Individual
AMANDA MARIE ANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, FNP
Contact information
Practice address
625 S NEW BALLAS RD STE 2030, SAINT LOUIS, MO 63141
(314) 251-1700
(314) 251-1701
Mailing address
625 S NEW BALLAS RD STE 2030, SAINT LOUIS, MO 63141-8253
(314) 251-1700
(314) 251-1701
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2002006436
MO
363LF0000X
Family Nurse Practitioner
Primary
2018031883
MO
Other
Enumeration date
08/29/2018
Last updated
09/05/2018
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