Bodenstab, Johnna L

Bodenstab, Johnna L is an individual health care provider with primary practice located at 17611 East 24 Highway Suite 200, Independence MO 64055-1823. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Bodenstab, Johnna L can be contacted via phone (816) 257-7787.

Contact Information

Primary practice address
17611 East 24 Highway Suite 200 Independence MO 64055-1823
Phone: (816) 257-7787
Fax: (816) 257-6948
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 100447 Missouri
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 100447 Missouri

Profile Details

NPI number 1619968070
LBN Legal business name Bodenstab, Johnna L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 3rd, 2005
Last updated Aug 20th, 2007 - about 17 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 1619968070 NPPES
Missouri Other 000C892 MEDICARE NUMBER

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