Individual
MICHELLE LOUISE WALLWEBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
21 MEADOWS CIRCLE DR STE 324, LAKE ST LOUIS, MO 63367-4110
(636) 389-2488
Mailing address
18 STRAWGRASS CT, SAINT CHARLES, MO 63304-2301
(314) 495-8821
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2002019911
MO
363LF0000X
Family Nurse Practitioner
Primary
2024001831
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2024001831
STATE OF MO CERTIFIED NURSE PRACTITIONER
MO
Enumeration date
08/16/2023
Last updated
01/18/2024
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