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Individual

LAURELL A CONDER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
100 MAIN ST, GIDEON, MO 63848
(573) 448-3800
(573) 448-8909
Mailing address
901 W COMMERCIAL ST, KENNETT, MO 63857-1100
(573) 717-1072
(573) 559-2289

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
122452
AR
363LF0000X
Family Nurse Practitioner
Primary
2019022745
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420074761
MO
Enumeration date
06/25/2019
Last updated
02/03/2020
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