Individual
TAHRA S LOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
3801 S NATIONAL AVE FL 9, SPRINGFIELD, MO 65807-5210
(417) 269-5158
(417) 269-4470
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
(417) 730-6430
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021028370
MO
Other
Enumeration date
12/29/2021
Last updated
04/06/2023
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