Individual
MARY L. AGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
118 W DALLAS ST, BUFFALO, MO 65622-8669
(417) 345-6101
(417) 345-6913
Mailing address
PO BOX 2580, SPRINGFIELD, MO 65801-2580
(417) 829-4620
(417) 829-4316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
076409
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423844307
—
MO
Enumeration date
10/17/2006
Last updated
07/17/2008
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