Individual
MARY ELIZABETH WATERHOUSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGNP-BC
Contact information
Practice address
210 JACKSON STREET, MOUNTAIN VIEW, MO 65548
(573) 680-4905
Mailing address
PO BOX 548, MOUNTAIN VIEW, MO 65548
(573) 680-4905
(417) 934-6817
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2015040090
MO
Other
Enumeration date
05/27/2016
Last updated
05/27/2016
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