Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2016017431 | MO |
NPI | 1003264920 |
---|---|
Provider Name | Brittany Lynn Delaughter |
First Address | Kansas City, MO 64180-1143 |
Second Address | Sikeston, MO 63801-5044 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2016 |
Last Update Date | 04/03/2021 |