| NPI | 1427566694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA JARRELL Office/Billing Supervisor 573-568-7377 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014044250) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MO 126560) |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2023-08-08 |