Acosta, Jennifer

Acosta, Jennifer is an individual health care provider with primary practice located at 4818 S Tujunga Dr , Springfield MO 65810-1125. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Acosta, Jennifer can be contacted via phone (785) 250-7910.

Contact Information

Primary practice address
4818 S Tujunga Dr Springfield MO 65810-1125
Phone: (785) 250-7910
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2016023555 Missouri

Profile Details

NPI number 1932318367
LBN Legal business name Acosta, Jennifer
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 22nd, 2007
Last updated Oct 19th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1932318367 NPPES
Missouri MEDICAID 220033618

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