Black River Healthcare, Inc.
NPI #1376841064 in Poplar Bluff, Missouri
Provider Information
- NPI Number
- 1376841064
- Entity Type
- Organization
- Organization Name
- Black River Healthcare, Inc.
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Mar 4, 2011
- Last Updated
- Jul 19, 2011
Practice Location
- Address
- 1879 N WESTWOOD BLVD
- City
- Poplar Bluff
- State
- Missouri
- ZIP Code
- 63901-2833
- Phone
- (573) 727-9793
Authorized Official
- Name
- MRS. SHELLY YVONNE GRESHAM, FNP
- Title
- FAMILY NURSE PRACTITIONER
- Phone
- (573) 727-9793
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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