Individual
AKIA JENAE WALTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1430 OLIVE ST STE 100, SAINT LOUIS, MO 63103-2303
(314) 678-3344
(314) 621-5006
Mailing address
1430 OLIVE ST STE 100, SAINT LOUIS, MO 63103-2303
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2013019341
MO
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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