Individual
NICKIE LYNN LUNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
304 E 20TH ST, CARUTHERSVILLE, MO 63830-2569
(573) 922-9138
Mailing address
304 E 20TH ST, CARUTHERSVILLE, MO 63830-2569
(573) 922-9138
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
01/21/2016
Last updated
01/21/2016
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