Individual
AMANDA FAE KITCHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
20 S SPRIGG ST, CAPE GIRARDEAU, MO 63703-6212
(573) 651-4177
Mailing address
20 S SPRIGG ST, CAPE GIRARDEAU, MO 63703-6212
(573) 651-4177
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2012015599
MO
Other
Enumeration date
10/22/2021
Last updated
10/22/2021
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