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Individual

CHANEL WISHNUFF

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4708 PROVIDENCE WOODS CIR, WENTZVILLE, MO 63385-3708
(636) 352-7789
Mailing address
4708 PROVIDENCE WOODS CIR, WENTZVILLE, MO 63385-3708
(636) 352-7789

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2025043137
MO

Other

Enumeration date
10/02/2025
Last updated
10/02/2025
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