Individual
SAMANTHA WATANAPONGSE POLLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
12125 WOODCREST EXECUTIVE DR STE 110, SAINT LOUIS, MO 63141-5009
(314) 789-2486
Mailing address
12125 WOODCREST EXECUTIVE DR STE 110, SAINT LOUIS, MO 63141-5009
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2020038833
MO
363LG0600X
Gerontology Nurse Practitioner
0121921
OK
Other
Enumeration date
08/19/2016
Last updated
06/09/2025
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