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Individual

ERICA JANE PELINSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.A. - C

Contact information

Practice address
128 E COMMERCIAL ST, LEBANON, MO 65536-3257
(573) 302-3990
(573) 302-2753
Mailing address
54 HOSPITAL DR, OSAGE BEACH, MO 65065-3050
(573) 302-3990
(573) 302-2753

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021042544
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1618PA
SC
05
1821371014
NC
05
22012848
MO
Enumeration date
09/23/2011
Last updated
04/01/2022
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