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Individual

BETTY LOU SCRIVNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, ANPC

Contact information

Practice address
14307 ROUTE A, RUSSELLVILLE, MO 65074-2782
(573) 782-9928
Mailing address
14307 ROUTE A, RUSSELLVILLE, MO 65074-2782
(573) 782-9928

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
059504
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
425939907
MO
Enumeration date
09/11/2008
Last updated
12/19/2008
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