Taylor Rae Altenthal, APRN
Nurse Practitioner, Family in Sikeston, MO. Individual provider (NPI-1).
NPI number1811548530
StatusActive
Last updated in NPPESJun 16, 2023
Details
- NPI
- 1811548530
- Entity type
- Individual (NPI-1)
- Name
- Ms. Taylor Rae Altenthal
- Credential
- APRN
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 24, 2019
- Certification date
- Jun 16, 2023
- Last updated
- Jun 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 2019025833 | MO | Yes |
Other names
- Taylor Rae Fuwell (Former Name)
Practice location
200 Pine StSikeston, MO 63801-3258
Phone 573-472-8850 · Fax 573-472-4050
Mailing address
6738 State Highway 77Benton, MO 63736-8238
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