Bjornstad, Mary J

Bjornstad, Mary J is an individual health care provider with primary practice located at 965 Mattox Dr , Sullivan MO 63080-2365. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Bjornstad, Mary J can be contacted via phone (573) 860-6000.

Contact Information

Primary practice address
965 Mattox Dr Sullivan MO 63080-2365
Phone: (573) 860-6000
Fax: (573) 860-6016
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 072682 Missouri

Profile Details

NPI number 1104935261
LBN Legal business name Bjornstad, Mary J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 30th, 2006
Last updated May 13th, 2021 - about 3 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 1104935261 NPPES
Missouri MEDICAID 425813508

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