Individual
MRS. BEVERLY D WOMBOLD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
855 ARDUSER DR, OSCEOLA, MO 64776-6278
(417) 646-8153
(471) 646-8379
Mailing address
855 ARDUSER DR, OSCEOLA, MO 64773
(417) 646-8159
(471) 646-8379
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
095597
MO
Other
Enumeration date
06/27/2008
Last updated
06/27/2008
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