Individual
PATTY DECLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CCM
Contact information
Practice address
506 SUMAC FIELD CT, ELLISVILLE, MO 63021-5974
(314) 920-9207
Mailing address
1391 NW 136TH AVE, SUNRISE, FL 33323-2800
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
108863
MO
Other
Enumeration date
01/20/2022
Last updated
01/20/2022
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