Provider Demographics
NPI:1992196778
Name:MENSE, ANNETTE NOEL (PA)
Entity Type:Individual
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First Name:ANNETTE
Middle Name:NOEL
Last Name:MENSE
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Gender:F
Credentials:PA
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Mailing Address - Street 1:3125 DR RUSSELL SMITH WAY
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:MO
Mailing Address - Zip Code:64836-7402
Mailing Address - Country:US
Mailing Address - Phone:417-359-1849
Mailing Address - Fax:417-237-7259
Practice Address - Street 1:3125 DR RUSSELL SMITH WAY
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MO
Practice Address - Zip Code:64836-7402
Practice Address - Country:US
Practice Address - Phone:417-359-1849
Practice Address - Fax:417-237-7259
Is Sole Proprietor?:No
Enumeration Date:2015-02-14
Last Update Date:2015-02-16
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Provider Licenses
StateLicense IDTaxonomies
MO2015004694363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant