Individual
ABISOLA E ABIMBOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7334 S LINDBERGH BLVD, SAINT LOUIS, MO 63125-4522
(866) 389-2727
Mailing address
6015 STAELY AVE, SAINT LOUIS, MO 63123-3460
(732) 763-0359
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041.447832
IL
163W00000X
Registered Nurse
2024037599
MO
363LF0000X
Family Nurse Practitioner
Primary
2024039031
MO
363LF0000X
Family Nurse Practitioner
209.030308
IL
Other
Enumeration date
09/11/2024
Last updated
12/11/2024
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