Individual
MS. STEPHANIE ELAINE HOUSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2013011757
MO
363LP2300X
Primary Care Nurse Practitioner
Primary
2013011757
MO
363LP2300X
Primary Care Nurse Practitioner
209013526
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659716181
—
MO
Enumeration date
05/10/2013
Last updated
09/08/2016
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