Individual
AMY WILLBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
600 MEDICAL DR, WENTZVILLE, MO 63385-3426
(636) 332-8482
Mailing address
115 CRIMSON OAKS CT, LAKE SAINT LOUIS, MO 63367-4593
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011039626
MO
Other
Enumeration date
03/14/2012
Last updated
03/14/2012
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