Individual
CHRISTA MARIE STOUTENBOROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, APRN, A-GNP-C
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
6802 WADLOW CT, GODFREY, IL 62035-4238
(636) 352-7854
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2020009326
MO
Other
Enumeration date
06/30/2020
Last updated
06/30/2020
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