Faithwalk Community Development Corporation
Organization Active NPI Nurse Practitioner · Paris, MO
NPI 1457778110 · NPPES record last updated Mar 19, 2014
Key facts
- NPI
- 1457778110
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2004028021 (MO)
- Legal business name
- FAITHWALK COMMUNITY DEVELOPMENT CORPORATION
- Practice address
- 514 Fox St.
Paris, MO 65275 - Phone
- (660) 327-5752
- Fax
- (660) 327-6233
- NPI assigned
- Mar 19, 2014
- Organization subpart
- No
Authorized official
- Name
- Miss Betty Wilson, NURSE PRACTIONER-LN#
- Title
- FNP-
- Phone
- (660) 327-5752
Practitioners 1
-
Harold Long, MRSS/CLERGY/PASTORAL
National Provider Directory
Locations
514 Fox St
Paris, MO 65275
Phone (660) 327-5752
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor |
101YA0400X | |||
| Mental Health Counselor |
101YM0800X | |||
| Pastoral Counselor |
101YP1600X | |||
| Nurse Practitioner |
363L00000X | 2004028021 | MO | Yes |
Addresses
Primary practice location
514 Fox St.
Paris, MO 65275
Mailing address
P.O. Box 119
514 Fox St.
Paris, MO 65275
Phone (660) 327-5752
Other providers in Paris, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2014. 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.