Individual
LAUREN ELAINE PETRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1423 N JEFFERSON AVE STE K100, SPRINGFIELD, MO 65802-1917
(417) 269-3915
(417) 269-3913
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2007034599
MO
363L00000X
Nurse Practitioner
Primary
2017008465
MO
Other
Enumeration date
10/27/2016
Last updated
05/14/2019
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