Individual
KATIE STAFFORD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12200 WEBER HILL RD STE 100, SAINT LOUIS, MO 63127-1569
(314) 698-2500
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2009005945
MO
363LF0000X
Family Nurse Practitioner
Primary
2018029917
MO
Other
Enumeration date
06/09/2018
Last updated
08/06/2024
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