Individual
ANTINIECE NICOLE MCPHEARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
719 BUTTERFLY APT 259, KALAMAZOO, MI 49009-3217
(314) 728-0474
Mailing address
4056 FINNEY AVE, SAINT LOUIS, MO 63113-3426
(314) 728-0474
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
2021036978
MO
376K00000X
Nurse's Aide
141824
MO
376K00000X
Nurse's Aide
Primary
—
—
Other
Enumeration date
01/19/2023
Last updated
06/16/2025
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