Individual
MRS. AMANDA GAIL PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3100 OAK GROVE RD, POPLAR BLUFF, MO 63901-1573
(583) 718-1863
Mailing address
RR 1 BOX 34, ELLSINORE, MO 63937-9704
(573) 718-1863
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2006022082
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
092728
MO
Other
Enumeration date
06/11/2013
Last updated
11/28/2023
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