Individual
MRS. SUSAN KAY TOEBBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1050 W 10TH ST, ROLLA, MO 65401
(573) 364-9000
(573) 426-2210
Mailing address
1050 W 10TH ST, ATTN: EXECUTIVE DIRECTOR OF PHYSICIAN CLINICS, ROLLA, MO 65401-2905
(573) 364-9000
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
129277
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015401
MEDICARE
—
05
—
507013605
—
MO
Enumeration date
07/17/2007
Last updated
08/22/2019
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