Doctor Name: | MRS. JACLYN DAWN CURNUTT |
NPI Number: | 1306192729 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | APN |
License Number: | 2012008767 |
Business Practice Address: | 105 S Ridgecrest Ave Nixa, MO - 657147807 |
Business Phone Number: | 4177258250 |
Business Fax Number: | |
Mailing Address: | 2828 N National Ave, Ste. 540 SPRINGFIELD |
State: | MO |
Postal Code: | 658034306 |
Phone Number: | 4178374000 |
Fax Number: | 4178754710 |
NPI Enumeration Date: | 08/03/2012 |
NPI Last Update Date: | 01/19/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 2012008767 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MO |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |