Individual
GEORGINA FUENTES VELASQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12101 WOODCREST EXECUTIVE DR STE 102, SAINT LOUIS, MO 63141-5047
(800) 427-1902
Mailing address
333 N SUMMIT ST FL 15, TOLEDO, OH 43604-2615
(800) 427-1902
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020026943
MO
Other
Enumeration date
10/26/2020
Last updated
09/19/2025
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