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OMNIA SALEM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6121 N HANLEY RD, BERKELEY, MO 63134-2003
(314) 615-0877
Mailing address
450 CHUKKER VLY, ELLISVILLE, MO 63021-2043

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2015006765
MO

Other

Enumeration date
06/23/2015
Last updated
06/23/2015
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