Individual
MS. CAROLYN SUE LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.P.N.P.
Contact information
Practice address
714 GRAVOIS RD, STE. 200, FENTON, MO 63026-7727
(636) 349-5437
(636) 349-6663
Mailing address
714 GRAVOIS RD, STE. 200, FENTON, MO 63026-7727
(636) 349-5437
(636) 349-6663
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
066304
MO
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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