Organization
MARION COUNTY HEALTH DEPT & HOME HEALTH AGENCY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CANDICE RENEE GOTTMAN RN (REGISTERED NURSE)
(573) 221-1166
Entity
Organization
Contact information
Practice address
3105 PALMYRA RD, HANNIBAL, MO 63401-2203
(573) 221-1166
(573) 221-1214
Mailing address
3105 PALMYRA RD, HANNIBAL, MO 63401-2203
(573) 221-1166
(573) 221-1214
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
2004008342
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
510622004
—
MO
Enumeration date
05/28/2014
Last updated
05/28/2014
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