Individual
DENISE L NETTLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7229 PASADENA BLVD, SAINT LOUIS, MO 63121-2914
(314) 281-0161
Mailing address
7229 PASADENA BLVD, ST. LOUIS, UNITED STATE 63121
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
824255694
—
MO
Enumeration date
02/05/2018
Last updated
02/05/2018
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