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Individual

TAIBATU MOHAMMED AWAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
21342 LADUFF RD, WAYNESVILLE, MO 65583-7808
(254) 462-2776
Mailing address
21342 LADUFF RD, WAYNESVILLE, MO 65583-7808
(254) 462-2776

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
896075
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
2023034485
MO

Other

Enumeration date
07/12/2023
Last updated
07/09/2025
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