Wound Solutions Of Semo Llc | |
1231 1st St Ste 8 Kennett MO 63857-2521 | |
(870) 898-0088 | |
Not Available |
Full Name | Wound Solutions Of Semo Llc |
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Speciality | Clinic/Center |
Location | 1231 1st St Ste 8, Kennett, Missouri |
Authorized Official Name and Position | Heather Stallings (OWNER) |
Authorized Official Contact | 8702732799 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Wound Solutions Of Semo Llc 1021 Neil Dr Jonesboro AR 72401-4462 Ph: () - | Wound Solutions Of Semo Llc 1231 1st St Ste 8 Kennett MO 63857-2521 Ph: (870) 898-0088 |
NPI Number | 1578340360 |
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Provider Enumeration Date | 09/13/2023 |
Last Update Date | 12/11/2023 |
Medicare PECOS PAC ID | 8325490261 |
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Medicare Enrollment ID | O20240117000309 |
Identifier | Type | State | Issuer |
---|---|---|---|
1578340360 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | (* (Not Available)) | Primary |
Provider Name | Brandy Susanne Heinley |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1316178643 PECOS PAC ID: 6002080801 Enrollment ID: I20111111000716 |
Provider Name | Lisa Simone Herzing |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1912210378 PECOS PAC ID: 8921280892 Enrollment ID: I20171115002153 |
Provider Name | Amber M Brown |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1508645474 PECOS PAC ID: 4183073547 Enrollment ID: I20240117000352 |
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