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General NPI Number Information
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NPI Number | 1851916340
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Entity Type | Organization
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Legal Business Name | TRANSFORMED LIFE AND HEALTH INC
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Dates
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Enumeration Date | 06/10/2020
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Last Update Date | 06/10/2020
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Provider Practice Location Address
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Address Line | 923 WINDSOR RD
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City | CHANUTE
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State | KS
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Zip | 66720-2546
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Country | US
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Telephone | 620-212-9466
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Fax |
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Provider Business Mailing Address
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Address Line | 2401 E 32ND ST STE 10-117
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City | JOPLIN
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State | MO
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Zip | 64804-3177
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | MARGARET ANN MATLOCK
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Credential | NP
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Telephone | 620-212-9466
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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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 |
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License Number State |
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