Maxwell, Theresa Rene

Maxwell, Theresa Rene is an individual health care provider with primary practice located at 1011 E Saint Maartens Dr , Saint Joseph MO 64506-2993. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Maxwell, Theresa Rene can be contacted via phone (816) 232-0185.

Contact Information

Primary practice address
1011 E Saint Maartens Dr Saint Joseph MO 64506-2993
Phone: (816) 232-0185
Fax: (816) 364-6225
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 096655 Missouri

Profile Details

NPI number 1780887109
LBN Legal business name Maxwell, Theresa Rene
Credentials RN, MSN, FNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2007
Last updated Sep 25th, 2013 - about 13 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 1780887109 NPPES
Missouri MEDICAID 624003109

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