Mary Elizabeth Waterhouse, AGNP-BC
Individual provider Active NPI Adult Health Nurse Practitioner · Mountain View, MO
NPI 1306294665 · NPPES record last updated May 27, 2016
Key facts
- NPI
- 1306294665
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Adult Health Nurse Practitioner 363LA2200X
- License
- 2015040090 (MO)
- Practice address
- 210 Jackson Street
Mountain View, MO 65548 - Phone
- (573) 680-4905
- NPI assigned
- May 27, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2015040090 | MO | MD | Adult Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signify Health, LLC | Current |
Accepting new patients |
Locations
2300 Main St
Fl 9
Kansas City, MO 64108
Phone (800) 416-1767
4055 Valley View Ln
Ste 400
Dallas, TX 75244
Phone (469) 466-7037
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Adult Health Nurse Practitioner | 363LA2200X | 2015040090 | MO | Yes |
Addresses
Primary practice location
210 Jackson Street
Mountain View, MO 65548
Mailing address
PO Box 548
Mountain View, MO 65548
Phone (573) 680-4905
Other providers in Mountain View, MO
- St Francis Hospital
- Patricia Alexa Summerford
- Coralee M. Thacker-Thompson
- Wal-Mart Stores East LP
- Walgreen Co
- Whetstone Boys Ranch
- Robert G Wilkie
- Willow Health Care Inc
- Willow Health Care Inc
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 May 27, 2016. 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.