Individual
KIRSTEN RUTH COLEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8566
Mailing address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8566
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
2014037193
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2014037193
MO
Other
Enumeration date
11/05/2014
Last updated
05/03/2016
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