Individual
TAMARA JOAN RUNGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3535 S JEFFERSON AVE STE 118, SAINT LOUIS, MO 63118-3907
(314) 773-1822
Mailing address
9847 CRESTWICK DR, SAINT LOUIS, MO 63128-1136
(314) 704-4737
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2019013005
MO
Other
Enumeration date
05/23/2019
Last updated
05/23/2019
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