Individual
MS. STAISY ESTER YOUNG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
12035 CHAPARRAL DR, BRIDGETON, MO 63044-2824
(314) 494-2584
Mailing address
2643 BLUE HERON, FORISSANT, MO 63031
(314) 494-2584
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2002031370
MO
363LW0102X
Women's Health Nurse Practitioner
2002031370
MO
Other
Enumeration date
01/06/2009
Last updated
06/09/2017
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