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Individual

SANDRA SUE GOVRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC, PMHNP-BC

Contact information

Practice address
15316 PERRY ST, OVERLAND PARK, KS 66221-7504
(913) 557-0007
Mailing address
7339 TOURNAMENT DR, SAINT LOUIS, MO 63129-7708
(903) 436-1582

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
104056
MO
363L00000X
Nurse Practitioner
735706
TX
363LF0000X
Family Nurse Practitioner
104056
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2021026634
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
104056
MISSOURI LICENSE
MO
01
735706
TEXAS LICENSE
TX
Enumeration date
11/30/2011
Last updated
11/15/2021
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