Individual
MS. MARY ELIZABETH FUNKHOUSER
Active
Individual
MS. MARY ELIZABETH FUNKHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2013038966
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420009997
—
MO
Enumeration date
07/22/2013
Last updated
11/15/2021
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