Individual
MS. SHAWANA S BRANCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(143) 675-8203
(314) 747-3338
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(143) 675-8203
(314) 747-3338
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
155025
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
155025
MO
Other
Enumeration date
10/11/2006
Last updated
08/21/2024
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