Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0200X | Nurse Practitioner - Pediatrics | 2008020303 | MO |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2012034195 | MO |
NPI | 1023369774 |
---|---|
Provider Name | Elyssa N Rapier |
First Address | Springfield, MO 65804-2700 |
Second Address | Springfield, MO 65804-2700 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 29/05/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
PENDING | (05) | AR |
PENDING | (05) | MO |
PENDING | RR MCR (01) | MO |