Individual
SAMANTHA L BRANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1101 HIGHWAY K, O FALLON, MO 63366-8431
(636) 379-6363
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-4369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016035534
MO
Other
Enumeration date
11/15/2016
Last updated
10/29/2020
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