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Individual

ALLISON F BAX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3308 W EDGEWOOD DR, SUITE B, JEFFERSON CTY, MO 65109-6891
(573) 893-7848
(573) 893-1984
Mailing address
PO BOX 1107, HEALTH BRANCH WEST, JEFFERSON CITY, MO 65102-1107
(573) 893-7848
(573) 893-1984

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2006022700
MO
363LF0000X
Family Nurse Practitioner
Primary
2011023149
MO

Other

Enumeration date
04/13/2011
Last updated
06/28/2012
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