Tracey Beaver
Individual provider Active NPI Case Manager/Care Coordinator · Kennett, MO
NPI 1487067377 · NPPES record last updated Jun 9, 2014
Key facts
- NPI
- 1487067377
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1201 Ely St
Kennett, MO 63857-1336 - Phone
- (573) 888-5925
- Fax
- (573) 717-7059
- NPI assigned
- Jun 9, 2014
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1201 Ely St
Kennett, MO 63857-1336
Mailing address
1201 Ely St
Kennett, MO 63857-1336
Phone (573) 888-5925
Other providers in Kennett, MO
- Tyler Batchelor
- Joseph Earl Bates
- Kayla Bates
- Krista K Bates
- Tyler A Battles
- Berley Beck
- Jeffrey Tyler Beck
- Melinda Gaye Becknell
- Erin Jon Bedwell
- Christina L Bellers
All providers in Kennett, MO · Case Manager/Care Coordinator in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 9, 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.