MS. JOHNNA L BODENSTAB ARNP NPI 1619968070

NPI Information

NPI: 1619968070
Provider Name: MS. JOHNNA L BODENSTAB, ARNP
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
17611 EAST 24 HIGHWAY
SUITE 200
INDEPENDENCE, MO
ZIP 64055
Phone: (816) 257-7787
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MS. Johnna L Bodenstab, ARNP is a family nurse practitioner in Independence, MO with 28 years of experience. MS. Johnna L Bodenstab, ARNP NPI is 1619968070. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

17611 EAST 24 HIGHWAY
SUITE 200
INDEPENDENCE, MO
ZIP 64055-823
Phone: (816) 257-7787
Fax: (816) 257-6948

The NPI 1619968070 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 8/20/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	100447	MISSOURI	No
2	363LF0000X	Nurse Practitioner	Family	100447	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000C892	OTHER	MISSOURI	MEDICARE NUMBER
2	Q03332	MEDICARE UPIN	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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