Pilot Grove Rural Health Clinic
Organization Active NPI Nurse Practitioner · Pilot Grove, MO
NPI 1316112154 · NPPES record last updated Apr 23, 2008
Key facts
- NPI
- 1316112154
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- Legal business name
- PILOT GROVE RURAL HEALTH CLINIC
- Practice address
- 212 College St
Pilot Grove, MO 65276-1005 - Phone
- (660) 834-5100
- Fax
- (660) 834-5101
- NPI assigned
- Apr 23, 2008
- Organization subpart
- No
Authorized official
- Name
- Mrs. Amy D Ledbetter
- Title
- Director of Operations
- Phone
- (573) 651-4488
Corporate family (same tax ID) 2
Practitioners 1
National Provider Directory
- Tax ID family
- Laurie a Beach
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner |
363L00000X | Yes |
Addresses
Primary practice location
212 College St
Pilot Grove, MO 65276-1005
Mailing address
212 College St
Pilot Grove, MO 65276-1005
Phone (660) 834-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 507476406 | Medicaid | MO |
Other providers in Pilot Grove, MO
- Janna Leigh Lammers
- Laurie a Beach
- Laurie a Beach
- Desiree A Mangone
- Pilot Grove C-4
- Lisa D Pyle
- Kacie Danae Reuter
- Evett M Schuster
All providers in Pilot Grove, MO · 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 Apr 23, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.