Individual
MS. FAITH JUANITA EULEMA RADOSEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1180 OLD JACKSON RD, FARMINGTON, MO 63640-3428
(573) 760-1700
Mailing address
1180 OLD JACKSON RD, FARMINGTON, MO 63640-3428
(573) 760-1700
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
163W00000X
Registered Nurse
Primary
2019024085
MO
183700000X
Pharmacy Technician
2014033320
MO
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
04/08/2015
Last updated
04/19/2021
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