Individual
MS. DONNA L WILLINGHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6124
(314) 454-4283
Mailing address
1 CHILDRENS PL, C B 8116, SAINT LOUIS, MO 63110-1002
(314) 454-6124
(314) 454-4283
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
075568
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
490520833001
—
IL
Enumeration date
07/18/2006
Last updated
10/22/2015
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