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WILLOW FAMILY MEDICINE, LLC
NPI 1720272834
Clinic/Center - Rural Health in Kennett, MO

Active since August 31, 2007
304 TEACO RD, SUITE A, KENNETT, MO 63857(573) 888-0303(573) 888-0304 Get Directions Write a Review

NPPES record last updated: February 7, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Willow Family Medicine, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WILLOW FAMILY MEDICINE, LLC (NPI 1720272834) is a healthcare organization registered as a rural health in Kennett, Missouri and active in the NPI registry since August 2007. The organization lists Jennifer Renee Puckett, Physician, Owner, as its authorized official.

NPPES Registry Identity

NPI1720272834
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NameWILLOW FAMILY MEDICINE, LLC
Location Address304 TEACO RD, SUITE AKennett, MO 63857-3266
Mailing Address304 Teaco Rd, Suite AKennett, MO 63857-3266 · (573) 888-0303 · Fax (573) 888-0304
Phone(573) 888-0303
Fax(573) 888-0304
Organization SubpartNo
Authorized OfficialJennifer Renee PuckettPhysician, Owner · (573) 888-0303
Enumeration DateAugust 31, 2007
Last NPPES UpdateFebruary 7, 2008
✔ NPI 1720272834 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in MO · 2006013170
Also ListedFamily MedicineTaxonomy 207Q00000X · License 2006013170 (MO)
304 TEACO RD, Kennett, MO 63857
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Other Identifiers 1

Medicare OSCAR/certification268968MO

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CANDACE SIPES NP
Nurse Practitioner
304 TEACO RD
KENNETT, MO 63857
Dunklin County (573) 559-3591
NELSON R PEREZ MD
Obstetrics & Gynecology
304 TEACO RD, SUITE G
KENNETT, MO 63857
Dunklin County (573) 888-4370
HEALTHCARE FOR WOMEN, INC.
Clinic/Center (Rural Health)
304 TEACO RD, SUITE G
KENNETT, MO 63857
Dunklin County (573) 888-4370
MASSEY FAMILY CARE
Family Medicine
304 TEACO RD, SUITE B
KENNETT, MO 63857
Dunklin County (573) 888-6100
KRISTINA LYNN WADLEY FNP-C
Nurse Practitioner (Primary Care)
304 TEACO RD
KENNETT, MO 63857
Dunklin County (573) 559-3591
DR. DANIEL RIVERA M.D.
Anesthesiology (Pain Medicine)
304 TEACO RD
KENNETT, MO 63857
Dunklin County (316) 775-8404
SUZANNE STEELE LCSW
Social Worker (Clinical)
304 TEACO RD
KENNETT, MO 63857
Dunklin County (573) 559-3591
CAROLYN HERBERT
Nurse Practitioner (Family)
304 TEACO RD
KENNETT, MO 63857
Dunklin County (573) 888-0001

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Willow Family Medicine, LLC's NPI number?

The NPI number for Willow Family Medicine, LLC is 1720272834. It was assigned to this organization in the NPPES registry on August 31, 2007.

Where is Willow Family Medicine, LLC located?

Willow Family Medicine, LLC is located at 304 Teaco Rd Suite A, Kennett, MO 63857. The listed phone number is (573) 888-0303.

What is Willow Family Medicine, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

When was this NPI record last updated?

The NPPES record for Willow Family Medicine, LLC was last updated on February 7, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.