MEDICARE: ELICIA SUTTON 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	363LF0000X	Family Nurse Practitioner	2014021867	MO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1508272618
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELICIA SUTTON FNP

Provider Business Mailing Address
First Line	:	PO BOX 505164
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63150-5164
Country	:	US
Telephone Number	:	417-829-4620
Fax Number	:

Provider Business Practice Location Address
First Line	:	940 W MOUNT VERNON ST
Second Line	:
City	:	NIXA
State	:	MO
Zip	:	65714-9618
Country	:	US
Telephone Number	:	417-724-5280
Fax Number	:	417-724-5278

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

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	07/09/2014

Similar Medicare Providers

1790077600 — DUSTIN RYAN TOMPKINS D.O.
Practice Location Address:

940 W MOUNT VERNON ST , SUITE 200
NIXA, MO
65714-9618

Practice Phone: 417-724-5300
Practice Fax: 417-724-5303

1760852347 — REBECCA TARATUTA
Practice Location Address:

940 W MOUNT VERNON ST , STE 100
NIXA, MO
65714-9618

Practice Phone: 417-724-5300
Practice Fax:

1497614903 — STACIA D HILL
Practice Location Address:

625 N GALILEO DR
NIXA, MO
65714-7893

Practice Phone: 417-861-6717
Practice Fax:

1609734516 — ELIZABETH ANN FLIEGE RBT, AMS
Practice Location Address:

116 W SHERMAN WAY STE 1
NIXA, MO
65714-9022

Practice Phone: 417-298-0984
Practice Fax: 417-374-7185

1255150819 — COMPLETE CARE CLINIC LLC
Practice Location Address:

103 N OLD WILDERNESS RD
NIXA, MO
65714-9057

Practice Phone: 417-576-0643
Practice Fax:

1457030397 — COMPLETE CARE CLINIC LLC
Practice Location Address:

103 N OLD WILDERNESS RD
NIXA, MO
65714-9057

Practice Phone: 417-576-0643
Practice Fax:

Directions to “ ELICIA SUTTON FNP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.