Individual
ROBERTA C STOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
227 MAIN ST., FESTUS, MO 63028
(636) 931-2700
(636) 931-2139
Mailing address
227 MAIN ST., FESTUS, MO 63028
(636) 931-2700
(636) 931-2139
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
043960
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
043960
LICENSE NUMBER
MO
Enumeration date
10/04/2006
Last updated
07/08/2007
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