Enrique De la Piedra

Individual provider Active NPI Skilled Nursing Facility · Linn, MO

NPI 1306258561 · NPPES record last updated May 22, 2014

Key facts

NPI
1306258561
Entity type
Individual (NPI type 1)
Primary specialty
Skilled Nursing Facility 314000000X
License
042107 (MO)
Practice address
196 Hwy 196
Linn, MO 65051-3500
Phone
(573) 897-0700
Fax
(573) 897-0400
NPI assigned
May 22, 2014
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
042107MOMDSkilled Nursing Facility

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X 042107 MO Yes

Addresses

Primary practice location

196 Hwy 196
Linn, MO 65051-3500

Mailing address

196 Hwy 196
Linn, MO 65051-3500
Phone (573) 897-0700

Other providers in Linn, MO

All providers in Linn, MO · Skilled Nursing Facility in Missouri

Sources for this page

Verify at the official NPI Registry.