Individual
MRS. ZOE MARIE WADSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CPNP
Contact information
Practice address
12255 DEPAUL DR SUITE 300, BRIDGETON, MO 63044
(314) 344-6021
(314) 344-6131
Mailing address
1309 PINETREE LANE, ST. LOUIS, MO 63119
(314) 402-0129
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2019011504
MO
Other
Enumeration date
12/10/2019
Last updated
10/27/2021
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