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Individual

BROOKE HERETH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, FNP

Contact information

Practice address
2475 BROADWAY BLUFFS DR, COLUMBIA, MO 65201-8148
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
(844) 853-8937

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2019023142
MO
363LF0000X
Family Nurse Practitioner
Primary
2024021041
MO

Other

Enumeration date
07/19/2024
Last updated
07/19/2024
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