Individual
TANYA TERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
128 WILLOTT SQUARE DR, SAINT PETERS, MO 63376-4141
(314) 583-4450
Mailing address
128 WILLOTT SQUARE DR, SAINT PETERS, MO 63376-4141
(314) 583-4450
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2009020542
MO
Other
Enumeration date
01/12/2017
Last updated
01/12/2017
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