Individual
MARIA LENA WALLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
3009 N BALLAS RD STE 359C, SAINT LOUIS, MO 63131-2324
(314) 996-4545
(314) 996-4546
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 996-4545
(314) 996-4546
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2004018016
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2009034346
MO
Other
Enumeration date
11/15/2009
Last updated
03/29/2021
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