Individual
CRYSTELLE WIONA CANUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1600 E BROADWAY, COLUMBIA, MO 65201-5844
(573) 815-8000
Mailing address
PO BOX 104240, JEFFERSON CITY, MO 65110-4240
(573) 635-5264
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019013218
MO
Other
Enumeration date
04/23/2019
Last updated
06/28/2023
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