Individual
LISA MARIE GREENWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
19515 BRUNE PKWY, WARRENTON, MO 63383-6505
(844) 853-8937
Mailing address
1800 COMMUNITY, CLINTON, MO 64735-8804
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2014036522
MO
363LF0000X
Family Nurse Practitioner
Primary
2019005387
MO
Other
Enumeration date
02/22/2019
Last updated
02/16/2021
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