Individual
BIBIAN ONYEACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10600 LEWIS AND CLARK BLVD, SAINT LOUIS, MO 63136-6005
(314) 340-6389
Mailing address
2172 KEEVEN LN, FLORISSANT, MO 63031-6502
(314) 532-5505
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
129858
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12803654
UMR
MO
Enumeration date
10/21/2014
Last updated
10/21/2014
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