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Individual

GREGORIA VILLARUEL-KIRK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3322 S CAMPBELL AVE STE T-1, SPRINGFIELD, MO 65807
(417) 220-4480
Mailing address
3322 S CAMPBELL AVE STE T-1, SPRINGFIELD, MO 65807-4980
(417) 220-4480

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
136786
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1588649651
MO
05
427406905
MO
01
P00262273
RR MEDICARE
Enumeration date
12/13/2005
Last updated
01/22/2024
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