Individual
MS. MARY L NEWSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, RNFA
Contact information
Practice address
405 SAVANNAH RIDGE DR, SAINT CHARLES, MO 63303-2918
(636) 244-0704
(636) 244-0704
Mailing address
405 SAVANNAH RIDGE DR, SAINT CHARLES, MO 63303-2918
(636) 244-0704
(636) 244-0704
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
059781
MO
Other
Enumeration date
12/20/2009
Last updated
12/20/2009
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