Individual
SAMANTHA M MINTERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3009 N BALLAS RD STE 387C, SAINT LOUIS, MO 63131-2324
(314) 996-5900
Mailing address
3009 N BALLAS RD STE 387C, SAINT LOUIS, MO 63131-2324
(314) 996-5900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2018024069
MO
363LF0000X
Family Nurse Practitioner
2018024069
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363LF0000X
—
MO
Enumeration date
02/12/2019
Last updated
03/02/2022
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