Individual
HOPE BENTRUP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12700 SOUTHFORK RD STE 100, SAINT LOUIS, MO 63128-3201
(314) 543-5284
Mailing address
111 HAWKS HAVEN DR, O FALLON, MO 63368-7676
(314) 620-5534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2023014718
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Enumeration date
01/06/2022
Last updated
07/31/2023
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