Provider Demographics
NPI:1144492547
Name:DOSS, CARRIE ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:CARRIE
Middle Name:ANN
Last Name:DOSS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:CARRIE
Other - Middle Name:ANN
Other - Last Name:ODNEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-0001
Practice Address - Country:US
Practice Address - Phone:573-882-1057
Practice Address - Fax:573-884-4267
Is Sole Proprietor?:No
Enumeration Date:2008-03-26
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004004972363LF0000X, 363LF0000X
KS14-97620-112163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1144492547Medicaid
KS200737940AMedicaid
MO152360579Medicare PIN
MOP00975479Medicare PIN
MOMA3347002Medicare PIN