Individual
FALLAN NICHOLE MAYABB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1013 N MAIN ST, SIKESTON, MO 63801-5043
(573) 472-7535
Mailing address
1013 N MAIN ST, SIKESTON, MO 63801-5043
(573) 472-7535
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
2015013287
MO
207V00000X
Obstetrics & Gynecology Physician
BP10039962
TX
Other
Enumeration date
04/27/2011
Last updated
03/15/2021
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