NPI 1194297416

Stacy Wisdom

Practitioner Technician Festus, MO

Practice location

Address: 227 Main St, Festus, MO 63028-1952
Phone: (636) 931-2700

Registered specialties

Technician Primary

Nursing Service Related Providers Taxonomy 374700000X

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Registry record

NPI: 1194297416
Entity type: Individual
Sex (as registered): Female
NPI issued: 27 Dec 2018
Record last updated: 27 Dec 2018

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.