Individual
MRS. TECONDA LASHELLE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-BC
Contact information
Practice address
11133 DUNN RD STE 2427, SAINT LOUIS, MO 63136-6163
(314) 653-4275
(314) 653-4376
Mailing address
11133 DUNN RD STE 2427, SAINT LOUIS, MO 63136-6163
(314) 653-5643
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2000174039
MO
363LA2200X
Adult Health Nurse Practitioner
2000174039
MO
Other
Enumeration date
09/23/2009
Last updated
11/23/2021
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