Individual
LEAH W WANGUI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
225 MYSTIC CV, O FALLON, MO 63368-9654
(314) 583-4665
Mailing address
225 MYSTIC CV, O FALLON, MO 63368-9654
(314) 583-4665
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017030468
MO
Other
Enumeration date
10/24/2017
Last updated
10/24/2017
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