Individual
GRACIA LOUIS NABHANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 634-2620
(573) 634-2033
Mailing address
1125 MADISON ST, JEFFERSON CITY, MO 65101-5227
(573) 634-2620
(573) 634-2033
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
111467
MO
207RS0012X
Sleep Medicine (Internal Medicine) Physician
111467
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204000707
—
MO
01
—
290011732
RAILROAD MEDICARE
MO
Enumeration date
09/27/2005
Last updated
02/11/2016
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