Individual
MRS. JILL M MCGRUDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,FNP-BC
Contact information
Practice address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 686-2411
(573) 686-8452
Mailing address
686 LESTER ST, POPLAR BLUFF, MO 63901-5025
(573) 686-2411
(573) 686-8452
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
147615
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659606713
—
MO
Enumeration date
10/07/2009
Last updated
09/15/2011
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