Individual
EILEEN LLEWELLYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1443 N ROBBERSON AVE, # 200, SPRINGFIELD, MO 65802-3840
(417) 269-8061
(417) 269-8087
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-8061
(417) 269-8087
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
115663
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
108494
BLUE CROSS OF MO
—
05
—
423269513
—
MO
Enumeration date
09/26/2006
Last updated
01/08/2013
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