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Individual

LENA GADDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
5 WOODBINE CT, WASHINGTON, MO 63090-5614
(636) 221-5867
Mailing address
5 WOODBINE CT, WASHINGTON, MO 63090-5614
(636) 221-5867

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2006029385
MO
164W00000X
Licensed Practical Nurse
Primary
7139
AK

Other

Enumeration date
08/28/2014
Last updated
08/28/2014
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