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General NPI Number Information
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NPI Number | 1952842775
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Entity Type | Organization
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Legal Business Name | CENTRAL METHODIST UNIVERSITY
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Dates
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Enumeration Date | 03/13/2017
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Last Update Date | 10/11/2024
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Provider Practice Location Address
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Address Line | 411 CENTRAL METHODIST SQ STE 204
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City | FAYETTE
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State | MO
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Zip | 65248-1104
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Country | US
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Telephone | 660-248-6285
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Fax | 660-248-6266
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Provider Business Mailing Address
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Address Line | 411 CENTRAL METHODIST SQ
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City | FAYETTE
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State | MO
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Zip | 65248-1104
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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 | DIR OF STUDENT HEALTH SERV, FNP
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Name | CHRISTINA CORINNE KIRKENDOLL
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Credential | MSN, APRN, NP-C
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Telephone | 660-248-6285
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LS0200X
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Taxonomy Name | School Nurse Practitioner
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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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