Individual
LAUREN STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1229 E SEMINOLE ST, STE 520, SPRINGFIELD, MO 65804-2227
(417) 820-5750
Mailing address
1229 E SEMINOLE ST, SUITE 520, SPRINGFIELD, MO 65804-2227
(417) 820-5750
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1184083263
—
MO
01
—
PENDING
RR MEDICARE
MO
Enumeration date
02/17/2016
Last updated
06/28/2017
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