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1659980951
STACEY SHORES
KIRKSVILLE, MO
NPI
1659980951
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: MO 2009022767)
Enumeration Date
2020-07-23
Last Update Date
2020-07-23
Business Address
STACEY SHORES
900 E LAHARPE ST
KIRKSVILLE, MO 63501-4520
Phone number: 636-224-1210
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Mailing Address
STACEY SHORES
1601 OLD SOUTH RIVER RD
SAINT CHARLES, MO 63303-4120
Phone number: 636-224-1210
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