Individual
MS. JULIE LYNNE WATERBURY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.P.R.N.-F.N.P
Contact information
Practice address
10420 OLD OLIVE STREET RD STE 205, SAINT LOUIS, MO 63141-5937
(314) 504-4698
(314) 692-9978
Mailing address
10420 OLD OLIVE STREET RD STE 205, SAINT LOUIS, MO 63141-5937
(314) 504-4698
(314) 692-9978
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2011023150
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2011023150
MO
Other
Enumeration date
11/30/2010
Last updated
01/24/2018
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