Individual
MRS. TABITHA MARIE BAUDENDISTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
BSN, RN, MSN, FNP-C
Contact information
Practice address
154 SAINT PETERS CENTRE BLVD, SAINT PETERS, MO 63376-1695
(636) 552-9647
(636) 206-8548
Mailing address
7409 LEONA ST, SAINT LOUIS, MO 63116-2733
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2024009298
MO
Other
Enumeration date
03/08/2024
Last updated
03/24/2026
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