Individual
REDONDA MARSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, BC,FNP
Contact information
Practice address
1605 E BROADWAY, STE 110, COLUMBIA, MO 65201-8023
(573) 815-8130
(573) 815-8149
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(573) 815-8130
(573) 815-8149
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
102896
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423962026
—
MO
Enumeration date
04/25/2006
Last updated
06/14/2017
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