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Individual

SUSAN ALICE COLBURN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ANP-C

Contact information

Practice address
5000 MANCHESTER AVE, SAINT LOUIS, MO 63110-2012
(314) 747-5800
Mailing address
16 N BARAT AVE, SAINT LOUIS, MO 63135-2116
(314) 521-0177

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
125713
MO

Other

Enumeration date
08/27/2008
Last updated
08/27/2008
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