Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2200X | Nurse Practitioner - Adult Health | 148478 | MO |
N | 363LA2200X | Nurse Practitioner - Adult Health | 2012034634 | MO |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 2012034634 | MO |
NPI | 1003167735 |
---|---|
Provider Name | Terri Fletcher |
First Address | Lexington, MO 64067-1101 |
Second Address | Higginsville, MO 64037-1171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2012 |
Last Update Date | 31/10/2012 |