Individual
MINYO LYNNE TICER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 755-2305
Mailing address
1701 LACEY ST, CAPE GIRARDEAU, MO 63701-5230
(573) 755-2305
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2013027222
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2013027222
MISSOURI NURSING LICENSE NUMBER
MO
Enumeration date
07/30/2013
Last updated
07/30/2013
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