Individual
LAURA K NUTZELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-2064
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2010015986
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1336469196
—
MO
05
—
190330758
—
AR
01
—
431560263
TRICARE
MO
01
—
P00912959
RR MCR
MO
Enumeration date
06/03/2010
Last updated
04/20/2013
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