MEDICARE: JAYNA C HARPER FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	103115	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00670961	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	431560263	OTHER	TRICARE WEST
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1437329331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYNA C HARPER FNP

Provider Business Mailing Address
First Line	:	PO BOX 2580
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65801-2580
Country	:	US
Telephone Number	:	417-829-4620
Fax Number	:

Provider Business Practice Location Address
First Line	:	2115 S FREMONT AVE
Second Line	:	STE 3050
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-2239
Country	:	US
Telephone Number	:	417-820-3905
Fax Number	:	417-820-3528

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2008
Last Update Date	:	11/21/2012

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Directions to “ JAYNA C HARPER FNP” Practice Location

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