Individual
COLLEEN WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CPNP
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5674
(314) 268-4141
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5674
(314) 268-4141
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2004023208
MO
Other
Enumeration date
05/20/2009
Last updated
10/30/2020
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