GRACE GOMBE MUNTHALI (NPI# 1770949406) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770949406 |
| Entity Type | Individual |
| Full Name | GRACE GOMBE MUNTHALI |
| Credential | APRN, NP,RN |
| Practice Address |
600 E 5th St Fulton MO 65251-1753 |
| Practice Telephone | 5735922623 |
| Mailing Telephone | 5735923409 |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2019-07-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 163W00000X | Registered Nurse | 2010002416 | MO | Nursing Service Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
2015025656 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
2018012589 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 227 Metro Dr, Jefferson City, MO 651091134 | 8884031071 |
| Street Address |
600 E 5TH ST |
| City | FULTON |
| State | MO |
| Zip Code | 65251-1753 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104878792 | State of Missouri | Psychiatric Hospital | 600 E 5th St, Fulton, MO 65251-1753 | 2006-05-16 |
| 1851916944 | Barbara Borde-koufie | Nurse Practitioner | 600 E 5th St, Fulton, MO 65251-1753 | 2020-06-15 |
| 1801411301 | Jacqueline Suzette Maragh-lawrence | Nurse Practitioner | 600 E 5th St, Fulton, MO 65251-1793 | 2020-06-10 |
| 1346872306 | Steven M Edwards | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2020-02-07 |
| 1073159539 | Justin M Wiseman | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2019-11-20 |
| 1982240438 | Alexis Calliope Nicole Reddig | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2019-11-20 |
| 1194369744 | Kirsten Deming Hunter | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2019-11-06 |
| 1720551666 | Kayla Collier | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2019-01-03 |
| 1861969479 | Jennie L Brooks | Psychologist | 600 E 5th St, Fulton, MO 65251-1753 | 2018-11-01 |
| 1588150973 | Ashleigh Fox | Social Worker | 600 E 5th St, Fulton, MO 65251-1753 | 2018-07-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174008023 | East Central Missouri Behavioral Health Services, Inc. | Psychiatry & Neurology | 581 Commons Drive, Fulton, MO 65251 | 2018-09-26 |
| 1659888428 | Annette Marie Holt | Nurse Practitioner | 350 Country Meadows Lane, Fulton, MO 65251 | 2018-01-03 |
| 1922458454 | Benjamin Newell Crary | Family Medicine | 110 N Hosital Dr, Fulton, MO 65251 | 2016-06-15 |
| 1750763348 | Ssm Audrain Health Care, Inc | Clinic/Center | 350 Country Meadow Ln, Fulton, MO 65251 | 2015-06-19 |
| 1366829426 | Bigeye Emergency Physicians LLC | Emergency Medicine | 10 South Hospital Deive, Fulton, MO 65251 | 2015-04-28 |
| 1881019750 | Mid-missouri Hearing and Balance, Inc. | Audiologist-Hearing Aid Fitter | 850 W. Hospital Drive, Ste. G, Fulton, MO 65251 | 2014-02-28 |
| 1861828105 | Justin Ryan Campbell | Occupational Therapist | 508 Saint Eunice Road, Fulton, MO 65251 | 2013-09-18 |
| 1417257536 | June A Dillon | Counselor | 2625 Fairway Dr., Suite E, Fulton, MO 65251 | 2010-10-22 |
| 1033354196 | Michael K Mcelhinney | Specialist/Technologist | One University Avenue, William Woods University - Athletics, Fulton, MO 65251 | 2008-12-03 |
| 1326299967 | Karanbir Sandhu | Dentist | 1393 Highway O, Fulton, MO 65251 | 2008-10-01 |
| Find all providers in zip 65251 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295391530 | Dina Goodin | Nurse Practitioner | 10 S Hospital Dr, Fulton, MO 65251-2510 | 2019-05-13 |
| 1922540095 | Cynthia Susan Mehrer | Nurse Practitioner | 581 Commons Dr, Fulton, MO 65251-1408 | 2016-11-07 |
| 1316388754 | Fatten K Elkomy | Nurse Practitioner | 5060 County Road 306, Fulton, MO 65251-5436 | 2013-07-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316545254 | Brenda S Halton | Nurse Practitioner | 1010 West Columbia Street, Farmington, MO 63640 | 2020-10-13 |
| 1376152546 | Chijioke Francisca Mbah | Nurse Practitioner | 900 Sw 33rd St, Lees Summit, MO 64082-4191 | 2020-07-23 |
| 1740807825 | Aldijana Sacic | Nurse Practitioner | 8525 Glenwood Dr, Saint Louis, MO 63126-1849 | 2020-07-06 |
| 1639796766 | Courtney Paige Schult | Nurse Practitioner | 431 Stonewater Dr, Pevely, MO 63070-3210 | 2020-07-06 |
| 1912524059 | Farah Lynn Shaddix | Nurse Practitioner | 1103 Warm Winds Dr, O Fallon, MO 63366-6327 | 2020-07-05 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1215551973 | Nicole Lynn Parker | Nurse Practitioner | 1000 Jackson St Apt 1, Saint Charles, MO 63301-2676 | 2020-05-28 |
| 1386273217 | Andrea Morrow Wright | Nurse Practitioner | 8833 N Congress Ave Apt 813, Kansas City, MO 64153-1991 | 2020-04-03 |
| 1700413580 | Solange-belle Boma | Nurse Practitioner | 6326 Ne 44th St, Kansas City, MO 64117-1687 | 2020-03-24 |
| 1063044626 | Beatriz Fortaleza | Nurse Practitioner | 2305 South 65 Highway, Bldg A., Marshall, MO 65340-3702 | 2020-02-11 |
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| 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.