Individual
MALLORY ELIZABETH STITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1301 1ST ST, KENNETT, MO 63857-2525
(573) 718-4038
Mailing address
40 KATHY CV, POPLAR BLUFF, MO 63901-2095
(573) 718-4038
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2016005888
MO
Other
Enumeration date
02/25/2016
Last updated
02/25/2016
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