Individual
HEATHER POPHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3009 N BALLAS RD, STE 207B, SAINT LOUIS, MO 63131-2322
(314) 996-7960
(314) 989-0235
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-7960
(314) 989-0235
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2011041207
MO
Other
Enumeration date
01/24/2012
Last updated
10/15/2014
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