Individual
LACI MAE DONNELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3525 E BATTLEFIELD ST, SPRINGFIELD, MO 65809-3434
(417) 269-1499
(417) 269-1459
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2012007890
MO
Other
Enumeration date
03/12/2012
Last updated
04/18/2022
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