Individual
DANIELLE MATHIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,APRN, FNP-BC
Contact information
Practice address
3440 DEPAUL LANE SUITE 201, BRIDGETON, MO 63044
(314) 291-3312
(314) 291-4641
Mailing address
10004 KENNERLY RD STE 137A, SAINT LOUIS, MO 63128-2140
(314) 842-7301
(314) 842-7308
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011029608
MO
Other
Enumeration date
09/19/2018
Last updated
08/14/2019
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