Individual
MITZI GERRETSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
301 S NEWPORT AVE, CONWAY, MO 65632-8322
(417) 589-2050
Mailing address
301 S NEWPORT AVE, CONWAY, MO 65632-8322
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016009385
MO
Other
Enumeration date
04/08/2016
Last updated
04/08/2016
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