Provider Demographics
NPI:1154599900
Name:GARTON, DANNY LEE (FNP)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:LEE
Last Name:GARTON
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PORTER AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:MO
Mailing Address - Zip Code:65605-2365
Mailing Address - Country:US
Mailing Address - Phone:417-678-2122
Mailing Address - Fax:417-678-7841
Practice Address - Street 1:500 PORTER AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:MO
Practice Address - Zip Code:65605-2365
Practice Address - Country:US
Practice Address - Phone:417-678-2122
Practice Address - Fax:417-678-7841
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2009-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000148465363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00689768OtherRAILROAD MEDICARE
AR175807758Medicaid
MO2000148465OtherLISCENSE
MO132300022Medicare PIN
AR175807758Medicaid