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General NPI Number Information
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NPI Number | 1821313081
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Entity Type | Organization
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Legal Business Name | EXPRESS PSYCH, LLC
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Dates
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Enumeration Date | 03/31/2010
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Last Update Date | 03/31/2010
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Provider Practice Location Address
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Address Line | 2727 E 32ND ST SUITE 9
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City | JOPLIN
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State | MO
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Zip | 64804-3156
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Country | US
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Telephone | 417-781-7200
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Fax | 417-781-7202
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Provider Business Mailing Address
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Address Line | 2727 E 32ND ST SUITE 9
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City | JOPLIN
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State | MO
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Zip | 64804-3156
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Country | US
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Telephone | 417-781-7200
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Fax | 417-781-7202
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Authorized Official
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Title or Position | ADULT PSYCHIATRIC CLINICAL NURSE SP
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Name | MS. PAMELA LYNN FAILLE
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Credential | RN, AP/MHCNSBC
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Telephone | 417-781-7200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number |
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License Number State |
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