Individual
AMY CHRISTINE WALQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4138 HIGHWAY TT, ODESSA, MO 64076-6354
(816) 506-8199
Mailing address
4138 HIGHWAY TT, ODESSA, MO 64076-6354
(816) 506-8199
Taxonomy
Speciality
Code
Description
License number
State
163WN1003X
Nutrition Support Registered Nurse
Primary
131713
MO
Other
Enumeration date
04/14/2020
Last updated
04/14/2020
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