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Individual

MOLLY LYNN MUDD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, CPNP-PC

Contact information

Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 477-9864
Mailing address
1 CHILDRENS PLACE, OFFICE 8W23, ST. LOUIS, MO 63110

Taxonomy

Speciality
Code
Description
License number
State
163WP0200X
Pediatric Registered Nurse
2008022120
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
20163161
MO

Other

Enumeration date
08/03/2017
Last updated
11/04/2021
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