Individual
NANCY ELLEN ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
1229 E SEMINOLE ST, SPRINGFIELD, MO 65804-2227
(417) 820-2064
Mailing address
ST. JOHN'S CLINIC, INC., P.O. BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
057795
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1841250859
—
MO
Enumeration date
03/24/2006
Last updated
05/18/2009
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