Individual
SUSANN NANCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
17811 E 24 HWY, INDEPENDENCE, MO 64056
(816) 257-5202
Mailing address
3501 SW FLEMING DR, BLUE SPRINGS, MO 64015-7124
(816) 805-6049
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
029255
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
604738708
—
MO
Enumeration date
10/05/2011
Last updated
10/05/2011
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