Individual
MARY BETH WUELLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2796 N HIGHWAY 67, FLORISSANT, MO 63033-1402
(314) 921-4445
(314) 921-5165
Mailing address
4251 FOREST PARK AVE, SAINT LOUIS, MO 63108-2810
(314) 531-7526
(314) 531-9731
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209005737
MO
Other
Enumeration date
09/06/2011
Last updated
09/06/2011
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