Angela S Declue, FNP | |
200 Health Way Dr, Potosi, MO 63664-1434 | |
(573) 438-2977 | |
(573) 438-2874 |
Full Name | Angela S Declue |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 200 Health Way Dr, Potosi, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1659343903 | NPI | - | NPPES |
428971402 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 132460 (Missouri) | Primary |
Entity Name | Washington County Memorial Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1194838821 PECOS PAC ID: 3476456880 Enrollment ID: O20040131000146 |
Entity Name | Potosi Emergency Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1881075349 PECOS PAC ID: 0648588541 Enrollment ID: O20150925001293 |
Mailing Address | Practice Location Address |
---|---|
Angela S Declue, FNP 200 Health Way Dr, Potosi, MO 63664-1434 Ph: (573) 438-2977 | Angela S Declue, FNP 200 Health Way Dr, Potosi, MO 63664-1434 Ph: (573) 438-2977 |
Penny Kaye Grechus, MSN, RN, PMHNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 573-438-7892 | |
Kristin R Jennings, DNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 573-438-9355 | |
Mr. Shawn Lenn Geile, APRN FNP BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 108 Frizzell St, Potosi, MO 63664 Phone: 573-438-8500 Fax: 573-438-8787 | |
Jessica Lynn Holland, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Southtowne Dr, Potosi, MO 63664 Phone: 572-438-9355 | |
Deirdre L Nivens, FAMILY NURSE PRACITI Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 200 Health Way Dr, Potosi, MO 63664 Phone: 573-438-2977 Fax: 573-438-2874 | |
Kallie Belfield, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 300 Health Way Dr, Potosi, MO 63664 Phone: 573-438-1778 | |
Donna Yates, RN, BC, FNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 600 Purcell Dr, Suite B, Potosi, MO 63664 Phone: 573-438-9355 Fax: 573-438-7892 |