Individual
WILSON GACHUGU NDUNGU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4 HAZELWOOD LN, HAZELWOOD, MO 63042-2711
(314) 425-9453
Mailing address
4 HAZELWOOD LN, HAZELWOOD, MO 63042-2711
(314) 425-9453
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2019003626
MO
363LA2200X
Adult Health Nurse Practitioner
2019003626
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
209020137
IL
363LG0600X
Gerontology Nurse Practitioner
2019003626
MO
363LG0600X
Gerontology Nurse Practitioner
209020137
IL
363LP2300X
Primary Care Nurse Practitioner
2019003626
MO
363LP2300X
Primary Care Nurse Practitioner
209020137
IL
Other
Enumeration date
03/04/2019
Last updated
04/14/2026
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