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NPI 1184116014ActiveOrganization· Nurse Practitioner, Adult Health· Florissant, MO
Nurse Practitioner, Adult Health in Florissant, Missouri, registered in NPPES in June 2018. The authorized official on file is Jeanetta Renee Stomer, NURSEPRACTITIONER, Co-Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1184116014 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jun 6, 2018 |
| Last updated in NPPES | Mar 28, 2020 |
| Certified by provider | Mar 28, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Adult Health Primary | 363LA2200X | 2011023084 | MO |
| Nurse Practitioner, Family | 363LF0000X | 2004029626 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MO) |
|---|
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