Individual provider · Type 1 NPI
Ethan Davis Mallory, FNP-C
Family Nurse Practitioner · Joplin, MO
NPI number
1922976422
Active
Practice location
3201 Mcclelland Blvd, Suite B
Joplin, MO 64804
Mailing address
3708 Chelsea
Webb City, MO 64870-9572
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 2025036708 (MO) |
Family Nurse Practitioner: Definition to come...
2 other providers at this address
Other family nurse practitioner providers in Joplin
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- Brittany Ann Putt, CFNPFamily Nurse Practitioner Joplin, MO NPI 1043843626
- Susan Bounous, NPFamily Nurse Practitioner Joplin, MO NPI 1053645713
- Crystal Joy Dyer, FNP-CFamily Nurse Practitioner Joplin, MO NPI 1053861609
- Deborah BlinzlerFamily Nurse Practitioner Joplin, MO NPI 1063966802
- Heather Dawn Dennis, FNP-CFamily Nurse Practitioner Joplin, MO NPI 1073753745
- Andra J. Fontaine, FNP-CFamily Nurse Practitioner Joplin, MO NPI 1083890461
- Jessica L. Verheyen, NPFamily Nurse Practitioner Joplin, MO NPI 1093187619
About NPI 1922976422
Ethan Davis Mallory, FNP-C's National Provider Identifier is 1922976422, issued on Oct 27, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Joplin, MO. The record was last updated on Oct 27, 2025.