Individual
KIALY ANN MUDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4280 MID AMERICA LN STE 30, SAINT LOUIS, MO 63129-1202
(314) 782-2600
Mailing address
326 SUMMER TOP LN, FENTON, MO 63026-3946
(314) 809-8625
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020019127
MO
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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