Individual
VAN B HO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12774 BOENKER LN, BRIDGETON, MO 63044-2436
(314) 291-7997
(314) 739-1471
Mailing address
PO BOX 776874, CHICAGO, IL 60677-6874
(314) 291-7997
(314) 739-1471
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2019014169
MO
Other
Enumeration date
06/03/2020
Last updated
06/25/2024
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