Individual
LORIDAN BROMBEREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
24602 FALCON RD, LEBANON, MO 65536-6136
(417) 533-4013
Mailing address
24602 FALCON RD, LEBANON, MO 65536-6136
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015029409
MO
363LF0000X
Family Nurse Practitioner
A141748
IA
Other
Enumeration date
09/11/2015
Last updated
09/11/2015
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