Individual
GINA BERTINI THEISEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
1603 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3826
(636) 332-8228
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020031798
MO
363LF0000X
Family Nurse Practitioner
APN.0993335-NP
CO
Other
Enumeration date
10/13/2017
Last updated
11/24/2020
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