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General NPI Number Information
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NPI Number | 1508127168
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Entity Type | Individual
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Provider Name | MS. SUSAN MARGARET NEL
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Gender | Female
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Dates
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Enumeration Date | 05/30/2012
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Last Update Date | 05/30/2012
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Provider Practice Location Address
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Address Line | 1001 S RANGE LINE RD
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City | JOPLIN
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State | MO
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Zip | 64801-5585
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Country | US
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Telephone | 417-782-4802
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Fax | 417-625-2704
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Provider Business Mailing Address
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Address Line | 501 ASHMORE DR
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City | CARL JUNCTION
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State | MO
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Zip | 64834-9333
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Country | US
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Telephone | 417-310-7020
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Fax | 417-625-2704
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 2000164938
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License Number State | MO
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