Individual
TRACI LYNN CROSSKNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 STATE ROUTE VV, KENNETT, MO 63857-3834
(573) 559-2365
Mailing address
925 STATE ROUTE VV, KENNETT, MO 63857-3822
(573) 888-5925
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
052398
MO
Other
Enumeration date
04/26/2019
Last updated
04/26/2019
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