Individual
MS. STACEY MICHELE WARDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
10806 OLIVE BLVD, SAINT LOUIS, MO 63141-7773
(314) 993-7009
(314) 993-1535
Mailing address
PO BOX 7412061, CHICAGO, IL 60674-2061
(314) 993-7009
(314) 993-1535
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2001006665
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420095602
—
MO
Enumeration date
11/13/2014
Last updated
04/17/2025
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