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General NPI Number Information
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NPI Number | 1326935834
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Entity Type | Individual
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Provider Name | BETTY LYNN GROW APRN FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/18/2025
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 12967 HIGHWAY 17
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City | PLATO
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State | MO
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Zip | 65552-8786
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Country | US
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Telephone | 417-259-2737
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Fax | 417-259-2737
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Provider Business Mailing Address
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Address Line | 12967 HIGHWAY 17
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City | PLATO
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State | MO
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Zip | 65552-8786
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Country | US
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Telephone | 417-259-2737
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2025023623
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License Number State | MO
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