NPI 1013475771

Amber Star Wedge, LPN

Practitioner Licensed Practical Nurse Poplar Bluff, MO

Practice location

Address: 3001 Warrior Ln, Poplar Bluff, MO 63901-8685
Phone: (573) 686-1200

Registered specialties

Licensed Practical Nurse Primary

Nursing Service Providers Taxonomy 164W00000X Licence 2015033100 (MO)

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Registry record

NPI: 1013475771
Entity type: Individual
Sex (as registered): Female
NPI issued: 12 Mar 2019
Record last updated: 12 Mar 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.