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Individual

LAURA A. HEDIGER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
2230 S GLENSTONE AVE, SPRINGFIELD, MO 65804-3255
(417) 820-7278
(417) 820-4068
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(417) 829-4620

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
080311
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500410007
MARIAN CENTER PROVIDER
01
PENDING
AR BLUE SHIELD
AR
05
PENDING
MO
Enumeration date
07/27/2007
Last updated
03/12/2015
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