Individual provider · Type 1 NPI

Kathy A. Divine

Family Nurse Practitioner · Springfield, MO

NPI number 1730622705 Active

Practice location

1235 E Cherokee St
Springfield, MO 65804-2203

Mailing address

PO Box 505164
St. Louis, MO 63150-5164

Specialties and licenses

TaxonomyCodeLicense
Registered Nurse 163W00000X079888 (MO)
Family Nurse Practitioner Primary 363LF0000X2017003053 (MO)

Family Nurse Practitioner: Definition to come...

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About NPI 1730622705

Kathy A. Divine's National Provider Identifier is 1730622705, issued on Nov 23, 2016. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Springfield, MO. The record was last updated on Feb 3, 2017.