Individual
MS. SUZANNE MARIE EARL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN,BC,FNP
Contact information
Practice address
4900 ST HWY. 160, SUITE 2, THEODOSIA, MO 65761-6539
(417) 273-2300
(417) 273-2316
Mailing address
PO BOX 328, 4900 ST. HWY 160 SUITE 2, THEODOSIA, MO 65761-0328
(417) 273-2300
(417) 273-2316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
074879
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427550306
—
MO
Enumeration date
07/19/2006
Last updated
08/06/2013
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