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Individual

LARISA V KOVALEVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 257-8222
Mailing address
13601 RIVERWAY DR APT B, CHESTERFIELD, MO 63017-2678
(314) 238-6730

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021016885
MO

Other

Enumeration date
06/13/2022
Last updated
06/13/2022
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