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Individual

JOYCE ANNE STOUT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
205 WALNUT ST., ELLINGTON, MO 63638-0157
(573) 663-2525
(573) 663-7821
Mailing address
RR 3 BOX 75-B, ELLINGTON, MO 63638-9306
(573) 663-2655

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2001026512
MO

Other

Enumeration date
09/05/2006
Last updated
07/08/2007
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