Individual
MRS. BRANDI NICHOLE TABOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
735 W MAIN ST, FREDERICKTOWN, MO 63645-1113
(573) 783-8875
Mailing address
733 W MAIN ST STE B, FREDERICKTOWN, MO 63645-1143
(573) 783-8875
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2019011374
MO
363L00000X
Nurse Practitioner
2019011374
MO
Other
Enumeration date
04/17/2019
Last updated
10/05/2022
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