Individual
SHERMAINE CIERRA CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3469 SAINT MARK LN, SAINT ANN, MO 63074-2909
(314) 201-7661
Mailing address
3469 SAINT MARK LN, SAINT ANN, MO 63074-2909
(314) 201-7661
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
W137166001
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
84-2671703
—
MO
Enumeration date
08/31/2019
Last updated
08/31/2019
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