Individual
MRS. CHRISTINA MARIE IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
2765 RED CEDAR PARC DR S, O FALLON, MO 63368-6609
(636) 248-8072
Mailing address
2765 RED CEDAR PARC DR S, O FALLON, MO 63368-6609
(636) 248-8072
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018040232
MO
Other
Enumeration date
11/12/2018
Last updated
11/12/2018
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