Individual
AMBER NICOLE THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4483 DUNCAN AVE, SAINT LOUIS, MO 63110-1111
(314) 454-7055
Mailing address
612 AUBER DR, MANCHESTER, MO 63011-4101
(314) 378-4496
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
2015035202
MO
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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