Individual
MICHELLE WHITED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
200 SAINT MARY ST., PILOT KNOB, MO 63663
(573) 327-9803
Mailing address
PO BOX 506, PARK HILLS, MO 63601-0506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2013020014
MO
Other
Enumeration date
06/16/2014
Last updated
06/16/2014
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