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Individual

MARY WHITMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1501 SCHOOL RD, LAKE OZARK, MO 65049-9761
(877) 406-2662
Mailing address
PO BOX 777, RICHLAND, MO 65556-0777
(877) 406-2662

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
094867
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
425198702
MO
Enumeration date
09/20/2005
Last updated
05/17/2022
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