Cupp, Brenda M.

Cupp, Brenda M. is an individual health care provider with primary practice located at 100 Mercy Way Suite 320-330, Joplin MO 64804-4524. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cupp, Brenda M. can be contacted via phone (417) 781-5387.

Contact Information

Primary practice address
100 Mercy Way Suite 320-330 Joplin MO 64804-4524
Phone: (417) 781-5387
Fax: (417) 781-7174
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 123412 Missouri

Profile Details

NPI number 1366530628
LBN Legal business name Cupp, Brenda M.
Credentials DNP
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 11th, 2006
Last updated Nov 17th, 2017 - about 9 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 1366530628 NPPES
Oklahoma MEDICAID 200096720A
Oklahoma MEDICAID 424021004
Oklahoma MEDICAID 200406720B

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