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Individual

ERICA LYNN ROUSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
150 S MOUNT AUBURN RD STE 420, CAPE GIRARDEAU, MO 63703-4911
(573) 335-4448
(573) 335-4466
Mailing address
PO BOX 801143, KANSAS CITY, MO 64180-1143
(573) 331-5583
(573) 331-5079

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2015006212
MO
363LF0000X
Family Nurse Practitioner
Primary
2018025778
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420056941
MO
Enumeration date
06/07/2018
Last updated
03/02/2021
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