Individual
KIMBERLY ANN DEPTULA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
500 HOWDERSHELL RD, FLORISSANT, MO 63031-6450
(314) 687-2727
(314) 687-2672
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-1009
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2017001302
MO
363LF0000X
Family Nurse Practitioner
2017001302
MO
Other
Enumeration date
07/12/2017
Last updated
10/21/2020
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