MRS. GWENDOLYN BROYLES (NPI# 1497282008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1497282008 |
Entity Type | Individual |
Full Name | MRS. GWENDOLYN BROYLES |
Credential | PMHNP |
Practice Address |
840 Passover Rd Osage Beach MO 65065-2834 |
Practice Telephone | 5733020319 |
Mailing Telephone | 5733020319 |
Enumeration Date | 2017-05-12 |
Last Update Date | 2017-05-12 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 364SP0810X |
Clinical Nurse Specialist Specialization: Psych/Mental Health, Child & Family |
2016032658 | MO | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
840 PASSOVER RD |
City | OSAGE BEACH |
State | MO |
Zip Code | 65065-2834 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255432027 | Cesar E Munoz | Psychiatry & Neurology | 840 Passover Rd, Osage Beach, MO 65065-2834 | 2006-09-26 |
1306227061 | Kelly Bellis | Registered Nurse | 840 Passover Rd, Osage Beach, MO 65065-2834 | 2015-06-17 |
1518256635 | Debbie L Kelly | Nurse Practitioner | 840 Passover Rd, Osage Beach, MO 65065-2834 | 2011-03-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437778859 | Suzanne Marie Harris | Social Worker | 1191 State Highway Kk, Suite 101, Osage Beach, MO 65065 | 2020-04-15 |
1982172342 | Arrowhead Retirement Operations LLC | Skilled Nursing Facility | 6100 Arrowhead Drive, Osage Beach, MO 65065 | 2018-11-05 |
1245723337 | William T Mcfail | Counselor | 1191 State Hwy Kk, Suite 101, Osage Beach, MO 65065 | 2018-06-13 |
1588102263 | Jennifer Kiske | Physical Therapist | 5780 Osage Beach Parkway, Ste 220, Osage Beach, MO 65065 | 2017-02-02 |
1700207586 | Brenda Renee Spies | Pharmacist | 4252 Osage Beach Parkway, Osage Beach, MO 65065 | 2013-12-23 |
1154668465 | Paige Hedgpath Od, PC | Optometrist | 4645g Osage Beach Parkway, Osage Beach, MO 65065 | 2013-01-07 |
1649548330 | Missouri Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 300 Kestrel Lane, Lake Ozark, MO 65065 | 2011-12-08 |
1437399821 | Melissa Nicole Morgan | Physical Therapy Assistant | 5177 Vicus Castri, Osage Beach, MO 65065 | 2009-02-25 |
1730330911 | Raymond Don Baker | Preventive Medicine | 5476 Stone Ledge Cir, Osage Beach, MO 65065 | 2008-10-06 |
1457514259 | Lake Family Dentistry | Dentist | 1037 Palisades Blvd Ste 9, Osage Beach, MO 65065 | 2008-07-02 |
Find all providers in zip 65065 |
Taxonomy Code | 364SP0810X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Clinical Nurse Specialist |
Specialization | Psych/Mental Health, Child & Family |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154895308 | Rachel Lee Kranz | Clinical Nurse Specialist | 255 Spencer Rd Ste 201, Saint Peters, MO 63376-2576 | 2019-01-21 |
1134627730 | Yasmine King Fehr | Clinical Nurse Specialist | 9979 Winghaven Blvd Ste 202, O Fallon, MO 63368-3628 | 2018-01-29 |
City | OSAGE BEACH |
Zip Code | 65065 |
Please comment or provide details below to improve the information on MRS. GWENDOLYN BROYLES.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.