Individual
HEATHER WIKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3801 S NATIONAL AVE, SPRINGFIELD, MO 65807-5210
(417) 269-6000
Mailing address
1097 INDIAN GROVE LN, ROGERSVILLE, MO 65742-7669
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2020009258
MO
Other
Enumeration date
10/05/2021
Last updated
10/05/2021
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