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Individual

MINDY N CARLYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP

Contact information

Practice address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751
Mailing address
1101 W LIBERTY ST, FARMINGTON, MO 63640-1921
(573) 756-6751

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2000162882
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2000162882
MO FNP LICENSE
MO
Enumeration date
07/09/2008
Last updated
02/12/2021
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