Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251H1200X | Hand | 00912 | MO |
NPI | 1023132875 |
---|---|
Provider Name | Brenda Hughes Kreuter |
First Address | Lebanon, MO 65536-2073 |
Second Address | Osage Beach, MO 65065-3050 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 08/07/2007 |