Individual
AMY LALLATHIN
Active
Individual
AMY LALLATHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2014002993
MO
363LG0600X
Gerontology Nurse Practitioner
Primary
2018040401
MO
Other
Enumeration date
10/18/2018
Last updated
11/07/2018
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