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Individual

MEGAN SUSTAR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
R.N.

Contact information

Practice address
105 COUNTRY CLUB PL, BELLEVILLE, IL 62223-1913
(618) 207-9852
Mailing address
105 COUNTRY CLUB PL, BELLEVILLE, IL 62223-1913

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2010022387
MO
174H00000X
Health Educator

Other

Enumeration date
10/11/2016
Last updated
10/11/2016
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