Individual
BETTY ANNE NOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1600 N MISSOURI AVE, MARCELINE, MO 64658-1012
(660) 376-2038
Mailing address
1001 W WORLEY ST, COLUMBIA, MO 65203-2037
(573) 214-2314
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R8J07
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1508813833
—
MO
01
—
P00322457
RAILROAD MEDICARE
MO
Enumeration date
05/30/2006
Last updated
06/20/2014
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