Provider Demographics
NPI:1053964544
Name:ARMSTRONG, BRIAN MATTHEW (FNP-C)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:MATTHEW
Last Name:ARMSTRONG
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 45
Mailing Address - Street 2:
Mailing Address - City:HIGHLANDVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65669-0045
Mailing Address - Country:US
Mailing Address - Phone:417-827-0275
Mailing Address - Fax:
Practice Address - Street 1:475 MULLING DR
Practice Address - Street 2:
Practice Address - City:HIGHLANDVILLE
Practice Address - State:MO
Practice Address - Zip Code:65669-8455
Practice Address - Country:US
Practice Address - Phone:417-827-0275
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-23
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014004848207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine