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1003871393
IDA MCCRAE
DONIPHAN, MO
NPI
1003871393
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 086500)
Enumeration Date
2006-04-19
Last Update Date
2012-02-27
Business Address
Ms. IDA MCCRAE FNP
1 HOSPITAL DR
DONIPHAN, MO 63935-1274
Phone number: 573-996-7148
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Mailing Address
Ms. IDA MCCRAE FNP
PO BOX 989
POPLAR BLUFF, MO 63902-0989
Phone number: 573-778-0020
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