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MS. STEPHANIE NATASHA GIPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
4219 LACLEDE AVE, SUITE B, SAINT LOUIS, MO 63108-2814
(314) 286-4545
(314) 286-4542
Mailing address
4245 FOREST PARK AVE, ATTN: MWP-ACCOUNTING DEPT, SAINT LOUIS, MO 63108-2810
(314) 286-4545
(314) 286-4542

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2008035985
MO

Other

Enumeration date
12/09/2011
Last updated
12/09/2011
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