Individual
MRS. AMANDA MICHELLE HUXTABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP-C
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6000
Mailing address
540 SUMMIT AVE, WEBSTER GROVES, MO 63119-1964
(314) 346-0808
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2017008669
MO
Other
Enumeration date
09/06/2017
Last updated
09/06/2017
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