Individual
NATASHA EVON MCGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
12958 HIGH CREST ST, BLACK JACK, MO 63033-4552
(314) 258-1268
Mailing address
12958 HIGH CREST ST, BLACK JACK, MO 63033-4552
(314) 258-1268
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2016003867
MO
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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