Individual
AMANDA PICKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
40 MERAMEC TRAIL DR, BALLWIN, MO 63021-3331
(636) 923-2361
Mailing address
40 MERAMEC TRAIL DR, BALLWIN, MO 63021-3331
(636) 923-2361
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2002025435
MO
Other
Enumeration date
05/03/2022
Last updated
05/03/2022
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