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Individual

MRS. PATRICIA KAY BOUSE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RNC WHNP

Contact information

Practice address
106 W 4TH ST, APPLETON CITY, MO 64724-1402
(660) 476-2194
(660) 476-9241
Mailing address
424 SE 100TH RD, CLINTON, MO 64735-9442
(660) 885-3491

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
059306
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
070058
MO
05
29823019PIN 29824017
MO
Enumeration date
01/04/2007
Last updated
07/09/2007
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