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General NPI Number Information
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NPI Number | 1902096308
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Entity Type | Organization
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Legal Business Name | NEVADA URGENT CARE
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Dates
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Enumeration Date | 07/31/2007
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 111 N ELM ST
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City | NEVADA
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State | MO
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Zip | 64772-2609
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Country | US
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Telephone | 417-667-9000
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Fax | 417-667-9029
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Provider Business Mailing Address
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Address Line | PO BOX 307
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City | NEVADA
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State | MO
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Zip | 64772-0307
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Country | US
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Telephone | 417-667-9000
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Fax | 417-667-9029
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DEBORAH S ASBERRY
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Credential | NP
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Telephone | 417-667-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 089091
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License Number State | MO
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