Jackie Ann Burr Graue, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

110313 Issued in MO

Practice address

3415 MC Intosh Cir
Joplin, MO 64804-3651

Phone

(417) 347-1111

Fax

(417) 347-4064

NPI assigned

Feb 4, 2008

Last updated

Sep 24, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Jackie Ann Burr Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1202083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1222214400000",
    "number": "1972781847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 MC INTOSH CIR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043651",
            "telephone_number": "417-347-1111",
            "fax_number": "417-347-4064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3415 MC INTOSH CIR",
            "city": "JOPLIN",
            "state": "MO",
            "postal_code": "648043651",
            "telephone_number": "417-347-1111",
            "fax_number": "417-347-4064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRAUE",
        "first_name": "JACKIE",
        "middle_name": "ANN BURR",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-04",
        "last_updated": "2008-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MO",
            "license": "110313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACKIE",
            "last_name": "BURR",
            "middle_name": "ANN",
            "credential": "NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• David Glenn Grant, O.D.
• Delnorah Grant
• Rodney Grant, CRNA
• Thomas P Grant, DDS
• John R Graue II, M.S. AND TH.D
• Charles Leon Graves, M.D.
• Mary Flack Graves, P.T.
• Ryan S Graves
• Suzanne Gray, LMSW
• Great Anesthesia Services PC

• Family Nurse Practitioner in Joplin, MO
• Providers in Joplin, MO by specialty
• Family Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.