Individual
STEPHANIE NUGRAHENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6642 CLAYTON RD # 403, SAINT LOUIS, MO 63117-1602
(314) 332-7754
Mailing address
299 DEBALIVIERE AVE, #311, SAINT LOUIS, MO 63112
(314) 332-7754
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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