Individual
MARY KOPSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
615 S NEW BALLAS RD, SUITE YG 230, ST. LOUIS, MO 63141
(314) 251-5550
Mailing address
7263 BALSON AVE, 1W, ST. LOUIS, MO 63130
(314) 456-9858
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2019024727
MO
Other
Enumeration date
11/03/2020
Last updated
02/07/2024
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