Individual
DIANNE LYNN HALLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
601 E 14TH ST, SEDALIA, MO 65301-5972
(660) 286-8833
(660) 827-3742
Mailing address
25955 TRINCHERA RD, EDWARDS, MO 65326
(660) 438-5722
(660) 438-5722
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2006031855
MO
Other
Enumeration date
06/28/2007
Last updated
07/08/2007
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