Individual
JANA ETHEL REID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1211 PORTER WAGONER BLVD, WEST PLAINS, MO 65775-1826
(417) 349-2334
Mailing address
1211 PORTER WAGONER BLVD # 23, WEST PLAINS, MO 65775-1826
(417) 257-6762
(417) 257-5875
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2005007398
MO
Other
Enumeration date
02/16/2018
Last updated
07/09/2019
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