Johnna L Bodenstab, ARNP
Nurse Practitioner, Family in Independence, MO. Individual provider (NPI-1).
NPI number1619968070
StatusActive
Last updated in NPPESAug 20, 2007
Details
- NPI
- 1619968070
- Entity type
- Individual (NPI-1)
- Name
- Ms. Johnna L Bodenstab
- Credential
- ARNP
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 3, 2005
- Last updated
- Aug 20, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 100447 | MO | Yes |
| 363LA2200X | Nurse Practitioner, Adult Health | 100447 | MO |
Practice location
17611 East 24 HighwaySuite 200
Independence, MO 64055-1823
Phone 816-257-7787 · Fax 816-257-6948
Mailing address
17611 East 24 HighwaySuite 200
Independence, MO 64056-1823
Phone 816-257-7787 · Fax 816-257-6948
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