Provider Demographics
NPI:1639762818
Name:BAREFIELD, AMY S (RN, CCM)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:S
Last Name:BAREFIELD
Suffix:
Gender:F
Credentials:RN, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 286
Mailing Address - Street 2:
Mailing Address - City:LAWSON
Mailing Address - State:MO
Mailing Address - Zip Code:64062-0286
Mailing Address - Country:US
Mailing Address - Phone:816-222-4520
Mailing Address - Fax:833-828-1069
Practice Address - Street 1:32935 W 196TH ST
Practice Address - Street 2:
Practice Address - City:LAWSON
Practice Address - State:MO
Practice Address - Zip Code:64062-8340
Practice Address - Country:US
Practice Address - Phone:816-222-4520
Practice Address - Fax:833-828-1069
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOMO-2001011862163W00000X
MOCCM-00097697163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163W00000XNursing Service ProvidersRegistered Nurse