| 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 |
|---|---|
| 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 |
|---|---|
| Wound Solutions of Semo LLC 1021 Neil Dr Jonesboro AR 72401-4462 | Wound Solutions of Semo LLC 1231 1st St Ste 8 Kennett MO 63857-2521 Ph: (870) 898-0088 |
| NPI Number | 1578340360 |
|---|---|
| Provider Enumeration Date | 09/13/2023 |
| Last Update Date | 12/11/2023 |
| Certification Date | 12/11/2023 |
| Medicare PECOS PAC ID | 8325490261 |
|---|---|
| Medicare Enrollment ID | O20240117000309 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578340360 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | () | Primary |
| Provider Name | Kayla Babb |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508484890 PECOS PAC ID: 8921414673 Enrollment ID: I20210304001595 |
| Provider Name | Allison Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063108280 PECOS PAC ID: 5799124582 Enrollment ID: I20250701001432 |
| Provider Name | Stefanie Lesley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225512635 PECOS PAC ID: 5092068205 Enrollment ID: I20250820004562 |
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