Impact Lifeline
Impact Lifeline is a Family Medicine Physician in Rolla, Missouri. Works from 2 locations. Registered with an NPI since 2025.
- In the registry since
- 2025
- Specialties on file
- 5
Practice location Address checks out
205 W 11th StRolla, MO 65401-2804
Phone: (314) 279-4565
Fax: (309) 326-4526
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 13191 Rich Ln, Rolla, MO 65401-7546 — (314) 279-4565
Specialties & licences
| Rural Health Clinic/Center (primary) | Taxonomy 261QR1300X |
|---|---|
| Family Medicine Physician | Taxonomy 207Q00000X |
| Public Health & General Preventive Medicine Physician | Taxonomy 2083P0901X |
| Home Infusion Agency | Taxonomy 251F00000X |
| Family Nurse Practitioner | Taxonomy 363LF0000X |
Record details
| NPI number | 1467257576 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Alisha Jones — Executive Administrator · (314) 279-4565 |
| NPI enumerated | February 14, 2025 |
| Last updated in NPPES | February 19, 2025 |
| Certification date | February 19, 2025 |
| Mailing address | 8 Laurelwood Ct, Saint Louis, MO 63146-4940 |
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