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Individual

MICHAEL JOHN MUNN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
APRN

Contact information

Practice address
33 GAGE DR, HOLLISTER, MO 65672-5862
(417) 334-8300
Mailing address
293 NORMAN RD, KIRBYVILLE, MO 65679-9332

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
113103
NE
363L00000X
Nurse Practitioner
Primary
20211036122
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420103556
MO
Enumeration date
02/29/2020
Last updated
10/19/2023
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