Healthcare Provider Details

I. General information

NPI: 1356080808
Provider Name (Legal Business Name): KRISTEL BARTON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2022
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 STATE ROUTE K
WEST PLAINS MO
65775
US

IV. Provider business mailing address

1500 N WESTWOOD BLVD
POPLAR BLUFF MO
63901-3318
US

V. Phone/Fax

Practice location:
  • Phone: 736-864-1515
  • Fax:
Mailing address:
  • Phone: 573-686-4151
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021047828
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA182037
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: