Individual
MS. REBECCA DIANNE RAIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, CPNP
Contact information
Practice address
1 CHILDRENS PL, 7E19, SAINT LOUIS, MO 63110-1002
(314) 454-4514
(314) 454-4761
Mailing address
3278 COUNTRY HOLLOW DR, SAINT LOUIS, MO 63129-7029
(314) 487-0222
(314) 487-0222
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
110918
MO
Other
Enumeration date
01/11/2008
Last updated
01/11/2008
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