Individual
CORTNY OSIE-ANN VANDERGRIFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 636-5248
Mailing address
9950 KRCMAR TRL, NEW BLOOMFIELD, MO 65063-1947
(573) 353-1138
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2019040282
MO
Other
Enumeration date
10/19/2019
Last updated
09/05/2023
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