Individual
MS. MARY BETH BRUEGGEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-BC
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
6054 SOUTHCREST WAY, SAINT LOUIS, MO 63129-2384
(314) 952-1929
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
079422
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429300205
—
MO
Enumeration date
04/30/2008
Last updated
04/30/2008
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