Individual
GLEN A MOHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
501 W PINE ST, FARMINGTON, MO 63640-1439
(573) 756-8888
Mailing address
501 W PINE ST, FARMINGTON, MO 63640-1439
(573) 756-8888
(573) 701-9547
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
142519
MO
Other
Enumeration date
05/16/2006
Last updated
03/17/2025
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