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Individual

ANGELA MARY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
1153 E ELM ST, SPRINGFIELD, MO 65806-2612
(866) 389-2727
Mailing address
1153 E ELM ST, SPRINGFIELD, MO 65806-2612
(866) 389-2727

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011006711
MO

Other

Enumeration date
04/26/2011
Last updated
06/17/2016
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