Individual
MISS PAULA JEAN DERUNTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
915 NORTH GRAND BLVD, VA MEDICAL CENTER, ST. LOUIS, MO 63106
(314) 289-6407
Mailing address
6330 LANSDOWNE AVE, SAINT LOUIS, MO 63109-2217
(314) 457-8324
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
103221
MO
363LA2200X
Adult Health Nurse Practitioner
103221
MO
Other
Enumeration date
04/26/2006
Last updated
04/06/2024
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