Provider Demographics
NPI:1689009011
Name:METRO NP ENTERPRISES LLC
Entity Type:Organization
Organization Name:METRO NP ENTERPRISES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:NP-C
Authorized Official - Phone:417-781-2046
Mailing Address - Street 1:1901 E 32ND ST
Mailing Address - Street 2:SUITE 20
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-3072
Mailing Address - Country:US
Mailing Address - Phone:417-781-2046
Mailing Address - Fax:417-781-2086
Practice Address - Street 1:1901 E 32ND ST
Practice Address - Street 2:SUITE 20
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-3072
Practice Address - Country:US
Practice Address - Phone:417-781-2046
Practice Address - Fax:417-781-2086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012028469261QP2300X
MO2012028473261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care