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Organization
MIDWEST WOUND & WELLNESS LLC
Active
Organization
MIDWEST WOUND & WELLNESS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY M ROBERTS FNP (OWNER)
(573) 747-1510
Entity
Organization
Contact information
Practice address
555 W PINE ST, FARMINGTON, MO 63640-1439
(573) 747-1510
(573) 747-1512
Mailing address
555 W PINE ST, FARMINGTON, MO 63640-1439
(573) 747-1510
(573) 747-1512
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
—
NULL
164W00000X
Licensed Practical Nurse
—
—
261Q00000X
Clinic/Center
Primary
—
NULL
Other
Enumeration date
06/18/2017
Last updated
07/21/2022
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