Individual
JEANETTA STOMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3391 N HIGHWAY 67, FLORISSANT, MO 63033-1604
(314) 736-1146
Mailing address
3391 N HIGHWAY 67, FLORISSANT, MO 63033-1604
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2004029626
MO
Other
Enumeration date
12/01/2016
Last updated
03/28/2020
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