Individual
SANDRA LEE MITKOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
108 FRIZZELL ST, POTOSI, MO 63664-1505
(573) 438-5408
(573) 438-2419
Mailing address
300 HEALTH WAY DR, POTOSI, MO 63664-1420
(573) 438-5451
(573) 438-2399
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2009036279
MO
Other
Enumeration date
12/29/2009
Last updated
04/25/2018
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