JAN LUCILE ALTISER PMHNP-BC NPI 1336478601

NPI Information

NPI: 1336478601
Provider Name: JAN LUCILE ALTISER, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1601 E 28TH ST
TRENTON, MO
ZIP 64683
Phone: (660) 359-4487
Get Directions

Jan Lucile Altiser, PMHNP-BC is a psychiatric/mental health nurse practitioner in Trenton, MO with 15 years of experience. Jan Lucile Altiser, PMHNP-BC NPI is 1336478601. 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:

1601 E 28TH ST
TRENTON, MO
ZIP 64683-178
Phone: (660) 359-4487
Fax: (660) 359-4129

The NPI 1336478601 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 12/16/2009 and was last updated on 2/3/2023.

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	363L00000X	Nurse Practitioner		2010013176	MISSOURI	No
2	363LF0000X	Nurse Practitioner	Family	2010013176	MISSOURI	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	2010013176	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	424240901	MEDICAID	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: 5/5/2024

NPI Synchronization or Removal

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