Holly Jean Kreienkamp

Individual provider Active NPI Transportation Broker · Cuba, MO

NPI 1013575612 · NPPES record last updated May 30, 2019

Key facts

NPI
1013575612
Entity type
Individual (NPI type 1)
Primary specialty
Transportation Broker 347E00000X
License
12042 (MO)
Practice address
571 Dotson Rd
Cuba, MO 65453-6146
Phone
(573) 259-3512
Fax
(573) 732-3172
NPI assigned
May 30, 2019
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
12042MOMDTransportation Broker

Practice roles

OrganizationSpecialtyStatusNew patients
Ability Express LLC Transportation Broker Current Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Transportation Broker 347E00000X 12042 MO Yes

Addresses

Primary practice location

571 Dotson Rd
Cuba, MO 65453-6146

Mailing address

571 Dotson Rd
Cuba, MO 65453-6146
Phone (573) 259-3512

Other names

  • Holly Jean Stout Former name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address hkreienkamp@abilityexpressllcc.com

Other providers in Cuba, MO

All providers in Cuba, MO · Transportation Broker in Missouri

Sources for this page

Verify at the official NPI Registry.