Individual
BECKY LYNN WITHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1060 W 10TH ST, ROLLA, MO 65401-2905
(855) 406-3324
(573) 458-8363
Mailing address
1050 W 10TH ST, ROLLA, MO 65401-2905
(855) 406-3324
(573) 458-8363
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014035055
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386047025
—
MO
Enumeration date
10/08/2014
Last updated
04/18/2025
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