Individual
DEREK CHRISTOPHER BRADDIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
9717 LANDMARK PARKWAY DR, SAINT LOUIS, MO 63127-1628
(775) 423-6400
Mailing address
1119 MISSISSIPPI AVE APT 115, SAINT LOUIS, MO 63104-2457
(314) 323-5316
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2016025007
MO
Other
Enumeration date
08/30/2016
Last updated
09/28/2020
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