Provider Demographics
NPI:1700080645
Name:TRAMMELL, ESTHER M (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:M
Last Name:TRAMMELL
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ESTHER
Other - Middle Name:M
Other - Last Name:MYERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1235 E CHEROKEE ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-2203
Mailing Address - Country:US
Mailing Address - Phone:417-820-6569
Mailing Address - Fax:
Practice Address - Street 1:1235 E CHEROKEE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-2203
Practice Address - Country:US
Practice Address - Phone:417-820-6569
Practice Address - Fax:417-820-6720
Is Sole Proprietor?:No
Enumeration Date:2007-06-13
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002019927363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1700080645Medicaid
MO132680690Medicare PIN
MO1700080645Medicaid
MO602630025Medicare PIN