| Street | 720 S Schifferdecker Ave | ||
| City/Town | Joplin | ||
| State/Province/Region | Missouri | ||
| Zip/Postal Code | 64801 | ||
| Phone Number | (417) 625-5100 | ||
| Country | United States |
| Full Name | Nellie Mertz | ||
| Gender | female | ||
| Birthday | 1979-10-03 | ||
| Social Security Number | 501-37-3045 |
| Credit card brand | EnRoute | ||
| Credit card number | 2149519132149581 | ||
| Expire | 2027/1 | ||
| CVV | 403 |