Individual
LACOSTA KAY GAINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
400 S CENTER ST, SHELBINA, MO 63468-1404
(573) 588-4131
(573) 588-4876
Mailing address
400 S CENTER ST, SHELBINA, MO 63468-1404
(573) 588-4131
(573) 588-4876
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015035184
MO
363LP2300X
Primary Care Nurse Practitioner
2015035184
MO
Other
Enumeration date
10/19/2015
Last updated
09/25/2023
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