| Kathleen Martin, CNP | |
| 
					3850 S National Ave, Suite 600, Springfield, MO 65807-5287  | |
| (417) 882-4880 | |
| (417) 882-7843 | 
| Full Name | Kathleen Martin | 
|---|---|
| Gender | Female | 
| Speciality | Nurse Practitioner | 
| Location | 3850 S National Ave, Springfield, Missouri | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1518307487 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2013019751 (Missouri) | Secondary | 
| 363L00000X | Nurse Practitioner | 2013019751 (Missouri) | Primary | 
| Entity Name | Community Care Health Network Llc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1619368842 PECOS PAC ID: 8527324151 Enrollment ID: O20210930001305  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Kathleen Martin, CNP 3850 S National Ave, Suite 600, Springfield, MO 65807-5287 Ph: (417) 882-4880  | Kathleen Martin, CNP 3850 S National Ave, Suite 600, Springfield, MO 65807-5287 Ph: (417) 882-4880  | 
Ven Thi Lam, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2828 N National Ave, Springfield, MO 65803 Phone: 417-837-4000 Fax: 417-875-4720  | |
Mrs. Erin Elizabeth Duvall, APRN, FNP-C, PMHNP-B Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1901 E Bennett - B, Springfield, MO 65804 Phone: 417-619-4129  | |
Michelle Spencer, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 2750 S Campbell Ave, Springfield, MO 65807 Phone: 417-269-2281 Fax: 417-269-2292  | |
Mrs. Cassondra Dawn Simmoneau, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 3800 S National Ave Ste 510, Springfield, MO 65807 Phone: 417-875-3000  | |
Beverly Jo Gann, RNC,WHNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2828 N National Ave, Doctors Hospital Of Springfield, Specialty Clinic, Springfield, MO 65803 Phone: 417-837-4000 Fax: 417-875-4724  | |
Ms. Jennifer L. Passanise, NP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1435 E Bradford Pkwy, Springfield, MO 65804 Phone: 417-881-4994 Fax: 417-881-4998  | |
Sally R Schafer, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1423 N Jefferson Ave, Springfield, MO 65802 Phone: 417-269-4636 Fax: 417-269-7036  |