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Individual

MICHELLE MARIE PATRICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4755
Mailing address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(859) 907-0311
(618) 233-5195

Taxonomy

Speciality
Code
Description
License number
State
207RI0011X
Interventional Cardiology Physician
20919119
IL
363LF0000X
Family Nurse Practitioner
2019007528
MO
363LF0000X
Family Nurse Practitioner
Primary
20919119
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F02191181
AMERICAN ACADEMY OF NURSE PRACTITIONERS
Enumeration date
04/04/2019
Last updated
05/20/2024
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