Individual
FAVIOLA MARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
AGPCNP
Contact information
Practice address
916 OLIVE ST, SAINT LOUIS, MO 63101-1459
(314) 436-9300
Mailing address
1805 OAK TREE ST, SAINT PETERS, MO 63376-6619
(314) 288-8317
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2015035373
MO
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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