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General NPI Number Information
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NPI Number | 1609459932
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Entity Type | Individual
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Provider Name | JACQUELINE RENEE' HENBEST NP
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Gender | Female
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Dates
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Enumeration Date | 05/04/2021
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 530 S MAIDEN LN
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City | JOPLIN
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State | MO
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Zip | 64801-3084
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Country | US
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Telephone | 417-782-7209
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Fax | 417-355-9407
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Provider Business Mailing Address
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Address Line | 212 SANDY FOREST LN
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City | CLEVER
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State | MO
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Zip | 65631-6840
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Country | US
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Telephone | 417-229-2188
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2021010391
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License Number State | MO
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