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Individual

MRS. PHYLLIS ANN HANSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
225 PHYSICIANS PARK, SUITE 203, POPLAR BLUFF, MO 63901-3935
(573) 686-4750
Mailing address
PO BOX 760, POPLAR BLUFF, MO 63902-0760
(573) 785-1822

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
093219
MO

Other

Enumeration date
10/02/2006
Last updated
05/14/2015
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