Individual
SHANNA VANDERBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2725 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-2346
(573) 686-5510
(573) 686-6846
Mailing address
2725 N WESTWOOD BLVD, POPLAR BLUFF, MO 63901-2346
(573) 686-5510
(573) 686-6846
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
132036
MO
Other
Enumeration date
04/27/2017
Last updated
04/27/2017
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