Individual
CHERIE LANHAM KIMBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
100 MEDICAL PLAZA DR, EMERGENCY DEPARTMENT, LAKE SAINT LOUIS, MO 63367
(636) 625-5300
(636) 625-5376
Mailing address
100 MEDICAL PLAZA DR, EMERGENCY DEPARTMENT, LAKE SAINT LOUIS, MO 63367
(636) 625-5300
(636) 625-5376
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2012008398
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
507602605
—
MO
Enumeration date
04/03/2012
Last updated
10/20/2021
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