Basic Information
| Provider Information | |||||||||
| NPI: | 1184686925 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | WOMENS HEALTH SPECIALISTS, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2340 KATY LN | ||||||||
| Address2: | |||||||||
| City: | POPLAR BLUFF | ||||||||
| State: | MO | ||||||||
| PostalCode: | 639012300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737767393 | ||||||||
| FaxNumber: | 5737767396 | ||||||||
| Practice Location | |||||||||
| Address1: | 2340 KATY LN | ||||||||
| Address2: | |||||||||
| City: | POPLAR BLUFF | ||||||||
| State: | MO | ||||||||
| PostalCode: | 639012300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5737767393 | ||||||||
| FaxNumber: | 5737767396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/05/2006 | ||||||||
| LastUpdateDate: | 03/08/2021 | ||||||||
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| AuthorizedOfficialLastName: | CARDA | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5732903293 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 03/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.