Individual
MS. JULIE A WHITWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGNP
Contact information
Practice address
5225 MID AMERICA PLZ, DIV IM MEDICAL ONCOLOGY, STE D115, SAINT LOUIS, MO 63129-0002
(800) 647-2098
(314) 362-3192
Mailing address
660 S EUCLID AVE, CB 8056, SAINT LOUIS, MO 63110-1010
(800) 647-2098
(314) 362-3192
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2014036356
MO
363LA2200X
Adult Health Nurse Practitioner
2014036356
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420020044
—
MO
Enumeration date
10/24/2014
Last updated
11/12/2021
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