Individual
JAMIE VANDERMIERDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1723 BROADWAY ST STE 210, CAPE GIRARDEAU, MO 63701-4556
(573) 331-7870
(573) 331-7899
Mailing address
1723 BROADWAY ST STE 210, CAPE GIRARDEAU, MO 63701-4556
(573) 331-7870
(573) 331-7899
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019019067
MO
Other
Enumeration date
06/10/2019
Last updated
06/10/2019
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