MONDRAKUS HARPER
NPI 1194426767
Technician, Pathology - Phlebotomy in Black Jack, MO

Active since March 13, 2023
12565 EVENING SHADE DR, BLACK JACK, MO 63033(314) 583-1477(314) 216-3926 Get Directions Write a Review

NPPES record last updated: March 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Individual
  • Male
  • Technician, Pathology
  • Phlebotomy

About MONDRAKUS HARPER

This page provides the complete NPI Profile along with additional information for Mondrakus Harper, a provider established in Black Jack, Missouri with a medical specialization in Technician, Pathology, focusing in phlebotomy . The healthcare provider is registered in the NPI registry with number 1194426767 assigned on March 2023. The practitioner's primary taxonomy code is 246RP1900X with license number B6P44F8Q3 (KY). The provider is registered as an individual and his NPI record was last updated 3 years ago.

NPI
1194426767 Verify this NPI
Provider Name
MONDRAKUS HARPER
Gender
Male
Entity Type
Individual
Location Address
12565 EVENING SHADE DR BLACK JACK, MO 63033
Location Phone
(314) 583-1477
Location Fax
(314) 216-3926
Mailing Address
12565 EVENING SHADE DR BLACK JACK, MO 63033
Mailing Phone
(314) 583-1477
Mailing Fax
(314) 216-3926
Is Sole Proprietor?
Yes
Enumeration Date
03-13-2023
Last Update Date
03-13-2023
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Technician, Pathology Phlebotomy

Taxonomy Code
246RP1900X
Type
Technologists, Technicians & Other Technical Service Providers
License No.
B6P44F8Q3
License State
KY

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
1376K00000XNursing Service Related Providers

Nurse's Aide

134849 (MO)

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Other Providers at the Same Location


The following 1 provider is registered at the same or a nearby location.

Home Health
12565 EVENING SHADE DR
BLACK JACK, MO 63033

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1194426767, enumerated as an "individual" on March 13, 2023.

The provider is located at 12565 EVENING SHADE DR BLACK JACK, MO 63033 and the phone number is (314) 583-1477.

Technician, Pathology with taxonomy code 246RP1900X and a focus in Phlebotomy.