Individual
CYNTHIA LYNN HOLLIS-KEENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
10520 W FARM ROAD 60, WALNUT GROVE, MO 65770-2825
(417) 268-7952
(417) 886-2774
Mailing address
10520 W FARM ROAD 60, WALNUT GROVE, MO 65770-2825
(417) 268-7952
(417) 886-2774
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
154542
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2015003170
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396067906
—
MO
Enumeration date
02/23/2010
Last updated
10/10/2024
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