Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 2016035606 | MO |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2016035606 | MO |
N | 363LG0600X | Nurse Practitioner - Gerontology | 2016035606 | MO |
NPI | 1003274440 |
---|---|
Provider Name | Mindy Doscher |
First Address | Saint Louis, MO 63141-8573 |
Second Address | Columbia, MO 65203-4469 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2016 |
Last Update Date | 17/03/2018 |