Healthcare Provider Details

I. General information

NPI: 1356659569
Provider Name (Legal Business Name): FRANCINE DIANE MEEK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2010
Last Update Date: 09/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 W 10TH ST STE A
ROLLA MO
65401
US

IV. Provider business mailing address

1000 W 10TH ST STE A
ROLLA MO
65401-2905
US

V. Phone/Fax

Practice location:
  • Phone: 573-364-5633
  • Fax: 573-426-5314
Mailing address:
  • Phone: 573-364-5633
  • Fax: 573-426-5314

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number089242
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: