Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2015001137 | MO |
NPI | 1003207242 |
---|---|
Provider Name | John R Armbruster |
First Address | Benton, MO 63736 |
Second Address | Cape Girardeau, MO 63701-5514 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/02/2015 |
Last Update Date | 21/02/2019 |