Individual
KIMBERLY ANN HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
2220 LEMP AVE, SAINT LOUIS, MO 63104-2700
(314) 898-1700
(314) 814-8542
Mailing address
PO BOX 551, SAINT LOUIS, MO 63188-0551
(314) 898-1700
(314) 814-8542
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016010218
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2008023243
LICENSE
MO
Enumeration date
06/06/2016
Last updated
03/03/2017
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