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General NPI Number Information
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NPI Number | 1558716571
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Entity Type | Individual
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Provider Name | ELIZABETH HARPER JUANILLO MD
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Gender | Female
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Dates
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Enumeration Date | 04/27/2016
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Last Update Date | 08/08/2025
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Provider Practice Location Address
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Address Line | 1720 W GRAND ST STE B
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City | SPRINGFIELD
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State | MO
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Zip | 65802-4802
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Country | US
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Telephone | 417-831-0150
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Fax |
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Provider Business Mailing Address
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Address Line | 440 E TAMPA ST
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City | SPRINGFIELD
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State | MO
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Zip | 65806-1131
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Country | US
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Telephone | 417-831-0150
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2025003048
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 59777
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License Number State | AZ
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