Individual
ROMAN HAILU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11525 OLDE CABIN RD, SAINT LOUIS, MO 63141-7146
(314) 997-0554
Mailing address
11525 OLDE CABIN RD, SAINT LOUIS, MO 63141-7146
(314) 997-0554
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2014019178
MO
363LF0000X
Family Nurse Practitioner
R 206334-6
MN
Other
Enumeration date
11/08/2012
Last updated
10/23/2024
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