Individual
LYNNE WHITESIDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
272 COBURG DR, SAINT LOUIS, MO 63137-3947
(314) 276-9957
Mailing address
272 COBURG DR, SAINT LOUIS, MO 63137-3947
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2011007725
MO
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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