Individual
ELIZABETH PEMBERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
306 HARBOUR POINTE DR, GROVER, MO 63040-1937
(314) 308-5424
Mailing address
306 HARBOUR POINTE DR, GROVER, MO 63040-1937
(314) 308-5424
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
2016012215
MO
363LG0600X
Gerontology Nurse Practitioner
Primary
2016012215
MO
Other
Enumeration date
08/30/2016
Last updated
08/30/2016
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