Individual
MS. PAMELA YVONNE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
REGISTER NURSE
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2017028448
MO
Other
Enumeration date
09/01/2020
Last updated
09/01/2020
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