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General NPI Number Information
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NPI Number | 1437428398
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Entity Type | Organization
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Legal Business Name | ADVANCED PROVIDER SERVICES, P.C.
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Dates
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Enumeration Date | 12/22/2011
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Last Update Date | 12/22/2011
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Provider Practice Location Address
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Address Line | 203 E MARKET ST
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City | BATES CITY
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State | MO
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Zip | 64011-9745
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Country | US
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Telephone | 816-896-0416
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Fax | 816-690-3147
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Provider Business Mailing Address
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Address Line | 901 S SPRUCE ST
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City | BATES CITY
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State | MO
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Zip | 64011-9707
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Country | US
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Telephone | 816-896-0416
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Fax | 816-690-3147
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | MRS. ANGELA JO HILBRENNER
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Credential | FNP-C
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Telephone | 816-896-0416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 104126
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License Number State | MO
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