Individual
MIRICLE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
92 MAIN ST, CASSVILLE, MO 65625-1610
(417) 847-5225
Mailing address
92 MAIN ST, CASSVILLE, MO 65625-1610
(417) 847-5225
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019005210
MO
Other
Enumeration date
02/20/2019
Last updated
02/20/2019
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