| Doctor Name: | RUTH THRELKELD |
| NPI Number: | 1134419799 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | 2011001368 |
| Business Practice Address: | 501 N Route B Hallsville, MO - 652559266 |
| Business Phone Number: | 5736960500 |
| Business Fax Number: | 5736960509 |
| Mailing Address: | 501 N Route B, HALLSVILLE |
| State: | MO |
| Postal Code: | 652559266 |
| Phone Number: | 5736960500 |
| Fax Number: | 5736960509 |
| NPI Enumeration Date: | 04/15/2011 |
| NPI Last Update Date: | 04/15/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 2011001368 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |