Individual
TARANEH MARYAM DIVANBEIGI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
4921 PARKVIEW PL, SAINT LOUIS, MO 63110-1032
(314) 454-8134
(314) 454-8104
Mailing address
680 MERAMEC STATION RD, VALLEY PARK, MO 63088-1133
(314) 368-0251
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2022048276
MO
Other
Enumeration date
12/29/2022
Last updated
12/29/2022
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