Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LF0000X | Nurse Practitioner - Family Medicine | 2013017565 | MO |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2013017565 | MO |
N | 363LP2300X | Nurse Practitioner - Primary Care | 2013017565 | MO |
NPI | 1003254087 |
---|---|
Provider Name | Mrs. Erin Elizabeth Duvall |
First Address | Springfield, MO 65804 |
Second Address | Springfield, MO 65804-6580 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2013 |
Last Update Date | 31/12/2020 |