Individual
MRS. KATHY J HALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
320 N MAC BOULEVARD, NEVADA, MO 64772
(417) 667-2262
(417) 667-6515
Mailing address
15196 E QUAIL RD, NEVADA, MO 64772-5366
(417) 684-7518
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2005024367
MO
Other
Enumeration date
09/14/2012
Last updated
09/14/2012
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