Individual
MONCHELLE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
200 WHITE RIVER DR, COLUMBIA, MO 65202-8693
(805) 696-5203
Mailing address
200 WHITE RIVER DR, COLUMBIA, MO 65202-8693
(805) 696-5203
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2020012929
MO
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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