Provider Demographics
NPI:1245529031
Name:ADVANCED PROVIDER SERVICES
Entity type:Organization
Organization Name:ADVANCED PROVIDER SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JO
Authorized Official - Middle Name:
Authorized Official - Last Name:HILBRENNER
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:816-896-0416
Mailing Address - Street 1:901 S SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:BATES CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64011-9707
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 SOUTH SPRUCE STREET
Practice Address - Street 2:
Practice Address - City:BATES CITY
Practice Address - State:MO
Practice Address - Zip Code:64011-9707
Practice Address - Country:US
Practice Address - Phone:816-896-0416
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-01
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011007384314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility