Patricia Kay Bouse, RNC WHNP

Individual provider Active NPI Women's Health Nurse Practitioner · Appleton City, MO

NPI 1013064898 · NPPES record last updated Jul 9, 2007

Key facts

NPI
1013064898
Entity type
Individual (NPI type 1)
Primary specialty
Women's Health Nurse Practitioner 363LW0102X
License
059306 (MO)
Practice address
106 W 4TH St
Appleton City, MO 64724-1402
Phone
(660) 476-2194
Fax
(660) 476-9241
NPI assigned
Jan 4, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
059306MOMDWomen's Health Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 059306 MO Yes

Addresses

Primary practice location

106 W 4TH St
Appleton City, MO 64724-1402

Mailing address

424 SE 100TH Rd
Clinton, MO 64735-9442
Phone (660) 885-3491

Other identifiers

IdentifierTypeStateIssuer
29823019PIN 29824017MedicaidMO
070058MedicaidMO

Other providers in Appleton City, MO

All providers in Appleton City, MO · Women's Health Nurse Practitioner in Missouri

Sources for this page

Verify at the official NPI Registry.