Individual
CAROL WELLONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3009 N BALLAS RD, SUITE 387C, SAINT LOUIS, MO 63131-2322
(314) 996-5900
(314) 996-5910
Mailing address
670 MASON RIDGE CENTER DR, SUITE 300, SAINT LOUIS, MO 63141-8573
(314) 996-5900
(314) 996-5910
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
097155
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425077013
—
MO
Enumeration date
08/30/2006
Last updated
03/31/2021
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