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Individual

MISS DELLA LOUISE ARIDGE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, MSN, NP

Contact information

Practice address
10004 KENNERLY RD, SUITE 330 A, SAINT LOUIS, MO 63128-2141
(314) 543-5963
(314) 525-4323
Mailing address
10004 KENNERLY RD, SUITE 330A, SAINT LOUIS, MO 63128-2141
(314) 543-5963
(314) 525-4323

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
063677
MO
363LF0000X
Family Nurse Practitioner
Primary
063677
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
13886
ANTHEM BLUE CROSS BLUE SH
MO
01
416213
HEALTHLINK
MO
05
425358702
MO
Enumeration date
10/20/2006
Last updated
01/25/2010
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