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Individual

STARLA KAY DULWORTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, BC, FNP

Contact information

Practice address
735 W MAIN ST, FREDERICKTOWN, MO 63645-1113
(573) 783-8875
(573) 783-8890
Mailing address
2200 B VARVARA ROAD, DOE RUN, MO 63637
(573) 760-0674
(573) 783-1096

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
117452
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
268942
MEDICARE RHC
05
597560408
MO
Enumeration date
12/01/2006
Last updated
07/26/2011
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