Individual
PAMELA WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1225 GRAHAM RD, FLORISSANT, MO 63031-8012
(314) 209-3900
Mailing address
1430 OLIVE ST STE 400, SAINT LOUIS, MO 63103-2303
(314) 206-3700
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2003021377
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2003021377
RN
MO
Enumeration date
10/02/2019
Last updated
10/02/2019
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