Individual
KELLY LYNN DILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Mailing address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2016038175
MO
363LF0000X
Family Nurse Practitioner
Primary
2016038175
MO
Other
Enumeration date
11/02/2016
Last updated
05/23/2022
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