Individual
DR. NEFRETITI MER-EN-RA GARRISON-NORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
211 SAINT FRANCIS DR, CAPE GIRARDEAU, MO 63703-5049
(573) 331-5770
(573) 331-3974
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2011012785
MO
208000000X
Pediatrics Physician
2011012785
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023019015
TRIWEST
MO
05
—
1042943
—
LA
01
—
P00314514
RAILROAD MEDICARE PIN
LA
Enumeration date
08/02/2005
Last updated
02/23/2021
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