Individual
MS. MARY K WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 454-2561
Mailing address
1 CHILDRENS PL, CB 8116, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 454-2561
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
090836
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423997709
—
MO
05
—
ENROLLED
—
IL
Enumeration date
04/10/2007
Last updated
01/29/2018
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