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Individual

AMY KELLAMS STINNETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
204 E 3RD ST, PORTAGEVILLE, MO 63873-1402
(573) 379-5467
(573) 379-5671
Mailing address
204 E 3RD ST, PORTAGEVILLE, MO 63873-1402
(573) 379-5467
(573) 379-5671

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2001008920
MO
363LF0000X
Family Nurse Practitioner
Primary
2001008920
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
42928806
MO
Enumeration date
10/26/2005
Last updated
04/01/2014
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