Individual
ALEXANDRA MAYBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3655 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-6056
Mailing address
233 N 1ST ST, BREESE, IL 62230-1617
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021018971
MO
Other
Enumeration date
01/07/2022
Last updated
01/07/2022
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