Individual
MS. LACRETIA M DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1520 WENTZVILLE PKWY, WENTZVILLE, MO 63385-3408
(636) 497-4055
(636) 344-1069
Mailing address
PO BOX 959354, SAINT LOUIS, MO 63195-9354
(636) 497-4055
(636) 344-1069
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
137786
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427204102
—
MO
Enumeration date
12/19/2008
Last updated
09/25/2025
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