Individual
NICOLE MENICHINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
16216 BAXTER RD STE 100, CHESTERFIELD, MO 63017-4778
(636) 449-4700
(636) 449-2595
Mailing address
16216 BAXTER RD STE 100, CHESTERFIELD, MO 63017-4778
(636) 449-4700
(636) 449-2595
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2016004551
MO
363LF0000X
Family Nurse Practitioner
Primary
2021004371
MO
Other
Enumeration date
01/27/2021
Last updated
02/04/2021
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