Organization
NP HEALTH INFORMATION STATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANETTA RENEE STOMER NURSEPRACTITIONER (CO-OWNER)
(314) 585-1002
Entity
Organization
Contact information
Practice address
3391 N HIGHWAY 67, FLORISSANT, MO 63033-1604
(314) 585-1002
(314) 736-1247
Mailing address
3391 N HIGHWAY 67, FLORISSANT, MO 63033-1604
(314) 585-1002
(314) 736-1247
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2011023084
MO
363LF0000X
Family Nurse Practitioner
2004029626
MO
Other
Enumeration date
06/06/2018
Last updated
03/28/2020
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