Most Relevant Information
Provider Data
| NPI Number: | 1003565896 |
| Provider Name: | ANNIE ROSE WALENDA |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 03/21/2022 |
| Last Updated: | 03/21/2022 |
Provider Practice Location
2995 WARRIOR LN
POPLAR BLUFF
MO
639018600
Practice Location Phone/Fax
| Phone: | 5737122902 |
| Fax: |
Provider Mailing Location
2995 WARRIOR LN
POPLAR BLUFF
MO
639018600
Provider Mailing Phone/Fax
| Phone: | 5737122902 |
| Fax: |