Individual
LORI SPARKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1565 SAINTE GENEVIEVE AVE, FARMINGTON, MO 63640-3454
(573) 756-5749
Mailing address
PO BOX 459, FARMINGTON, MO 63640-0459
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
41113472
MO
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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