Individual
SHELLIETTA MARIE MCTYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4000 JENNINGS STATION RD, SAINT LOUIS, MO 63121-3323
(314) 679-7819
Mailing address
4000 JENNINGS STATION RD, SAINT LOUIS, MO 63121-3323
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
2003006615
MO
Other
Enumeration date
12/17/2009
Last updated
12/17/2009
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