Individual
MRS. MARY ELLEN KANTZ
Active
Individual
MRS. MARY ELLEN KANTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, CNOR, CRNFA
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
044729
MO
163WR0006X
Registered Nurse First Assistant
Primary
044729
MO
Other
Enumeration date
09/02/2010
Last updated
12/06/2011
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