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Individual

DIANE STIERWALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
10012 KENNERLY RD, SUITE 403, SAINT LOUIS, MO 63128-2197
(314) 880-6676
(314) 842-4372
Mailing address
10012 KENNERLY RD, SUITE 403, SAINT LOUIS, MO 63128-2197
(314) 880-6676
(314) 842-4372

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041321448
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
041321448
LICENSE
IL
01
135330
LICENSE
MO
Enumeration date
06/30/2005
Last updated
04/07/2016
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