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General NPI Number Information
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NPI Number | 1518599646
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Entity Type | Individual
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Provider Name | TROY HENRY APRN
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Gender | Male
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Dates
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Enumeration Date | 02/06/2020
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Last Update Date | 11/10/2021
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Provider Practice Location Address
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Address Line | 707 VICTORY LN
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City | CAINSVILLE
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State | MO
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Zip | 64632-9506
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Country | US
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Telephone | 660-893-5750
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 803886
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City | KANSAS CITY
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State | MO
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Zip | 64180-3886
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Country | US
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Telephone | 816-307-4893
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A157851
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2020034567
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License Number State | MO
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