Dawn Marie Henry
Individual provider Active NPI Adult Health Nurse Practitioner · Mountain View, MO
NPI 1033713482 · NPPES record last updated Nov 25, 2020
Key facts
- NPI
- 1033713482
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 2020038956 (MO)
- Practice address
- 3925 County Road 3190
Mountain View, MO 65548-8261 - Phone
- (417) 247-1636
- NPI assigned
- Nov 25, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241230002442 | MO | Order and Referring Only - Nurse Practitioner | 5799193959 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020038956 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozarks Medical Center | Past | Accepting new patients | |
| Willow Health Care Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2020038956 | MO | Yes |
Addresses
Primary practice location
3925 County Road 3190
Mountain View, MO 65548-8261
Mailing address
3925 County Road 3190
Mountain View, MO 65548-8261
Phone (417) 247-1636
Other providers in Mountain View, MO
- Beverly J. Denton
- Don Andrew Dodd
- Julie Denise Dunn
- Michael K. Gaddy
- Kendra L Harralston
- Pearl Ann Hunter
- Katie Johnston
- Anne Kennedy
- Emily Carol Lovan
- Joseph Aaron Marino
All providers in Mountain View, MO · Adult Health Nurse Practitioner in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 25, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.