Individual
MANDIE DE VINCENTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, MSN, ANP-BC
Contact information
Practice address
15379 RED WILLOW CT, CHESTERFIELD, MO 63017-5426
(646) 354-9308
Mailing address
15379 RED WILLOW CT, CHESTERFIELD, MO 63017-5426
(646) 354-9308
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2013041187
MO
Other
Enumeration date
05/08/2014
Last updated
01/17/2020
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