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General NPI Number Information
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NPI Number | 1669290623
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Entity Type | Organization
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Legal Business Name | ROMO DIRECT PRIMARY CARE, LLC
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Dates
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Enumeration Date | 09/30/2024
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Last Update Date | 09/30/2024
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Provider Practice Location Address
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Address Line | 706 S BISHOP AVE STE A
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City | ROLLA
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State | MO
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Zip | 65401-4333
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Country | US
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Telephone | 573-995-2213
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Fax | 573-240-9752
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Provider Business Mailing Address
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Address Line | 1028 S. BISHOP AVE PMB 201
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City | ROLLA
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State | MO
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Zip | 65401
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Country | US
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Telephone | 573-995-2213
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Fax | 573-240-9752
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Authorized Official
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Title or Position | CEO
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Name | DR. STEPHANIE NICOLE HUHN
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Credential | DO
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Telephone | 314-973-6261
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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