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Individual

MARY MENZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
180 RAINBOW LAKE RD, SIKESTON, MO 63801-8752
(573) 258-2886
Mailing address
180 RAINBOW LAKE RD, SIKESTON, MO 63801-8752

Taxonomy

Speciality
Code
Description
License number
State
163WM0102X
Maternal Newborn Registered Nurse
Primary
2018021926
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
66383640
MO
Enumeration date
07/03/2022
Last updated
07/03/2022
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