Individual
MADISON PAIGE PENDERGRAFT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
3850 S NATIONAL AVE STE 600, SPRINGFIELD, MO 65807-5288
(417) 882-4880
(417) 882-7843
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(866) 266-0555
(866) 266-4999
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2018024713
MO
363L00000X
Nurse Practitioner
Primary
2023006102
MO
Other
Enumeration date
02/01/2023
Last updated
02/20/2023
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