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NPI 1275312050

NPI 1275312050 : CASSIE M GARRETT APRN : JOPLIN, MO

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General NPI Number Information
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    NPI Number           |    1275312050
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    Entity Type          |    Individual 
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    Provider Name        |    CASSIE M GARRETT APRN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    09/21/2023
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    Last Update Date     |    12/11/2023
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Provider Practice Location Address
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    Address Line         |    3202 MCINTOSH CIR STE 201 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64804-3686
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    Country              |    US
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    Telephone            |    417-347-8755
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    Fax                  |    417-347-8754
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Provider Business Mailing Address
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    Address Line         |    PO BOX 3810 
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    City                 |    JOPLIN
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    State                |    MO
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    Zip                  |    64803-3810
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    Country              |    US
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    Telephone            |    417-347-8755
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    Fax                  |    417-347-8754
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    363LF0000X
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    Taxonomy Name        |    Family Nurse Practitioner
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    License Number       |    2023033846
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    License Number State |    MO
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