Individual
BERNADETTE G ADDISON-TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
(314) 289-6595
Mailing address
401 HERN AVE, SAINT LOUIS, MO 63135-2644
(314) 398-6406
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
152562
MO
Other
Enumeration date
01/26/2024
Last updated
01/26/2024
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