Individual
STACY J MECKLENBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 996-5139
Mailing address
2144 COURTLEIGH LN, CHESTERFIELD, MO 63017-7623
(314) 406-5887
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
112477
MO
Other
Enumeration date
03/28/2023
Last updated
03/28/2023
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