Individual
MRS. CAROLYN MARIE MCGINNIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
419 SOUTHSIDE AVE, WEBSTER GROVES, MO 63119-4851
(314) 302-1126
Mailing address
419 SOUTHSIDE AVE, WEBSTER GROVES, MO 63119-4851
(314) 302-1126
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200901974
MO
363LA2100X
Acute Care Nurse Practitioner
Primary
2016000695
MO
Other
Enumeration date
03/29/2016
Last updated
05/17/2016
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