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Individual

MRS. LILA M MOURNING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP-C

Contact information

Practice address
101 E ROSS ST, CLEARWATER, KS 67026-7824
(620) 584-2055
(620) 584-2032
Mailing address
101 E ROSS ST, CLEARWATER, KS 67026-7824
(620) 584-2055
(620) 584-2032

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
44393
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
380770
FIRSTGUARD
KS
01
9781
PREFERRED PLUS OF KANSAS
KS
Enumeration date
08/21/2006
Last updated
07/08/2007
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