Individual
DR. KATIE ELIZABETH HERN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1605 MARTIN SPRINGS DR, STE 230, ROLLA, MO 65401-2931
(573) 458-6350
(573) 458-6764
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2010013487
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093936585
—
MO
01
—
431560263
TRICARE
MO
01
—
P01094294
RR MCR
MO
Enumeration date
05/01/2007
Last updated
12/12/2012
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