Individual
SHANITA GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3668 S GEYER RD, SAINT LOUIS, MO 63127-1249
(314) 821-8022
Mailing address
1321 N 8TH ST, SAINT LOUIS, MO 63106-4514
(314) 788-1437
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
20I5055
MO
Other
Enumeration date
05/09/2023
Last updated
05/09/2023
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