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Individual

MS. THERESA LEE MCQUAIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ANP

Contact information

Practice address
13065 OLD TESSON FERRY RD, SAINT LOUIS, MO 63128-3441
(314) 543-5222
Mailing address
13065 OLD TESSON FERRY RD, SAINT LOUIS, MO 63128-3441
(314) 543-5222

Taxonomy

Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
041-331941
IL
163WG0000X
General Practice Registered Nurse
RN117389
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
117389
MO
363LA2200X
Adult Health Nurse Practitioner
209-005264
IL
364S00000X
Clinical Nurse Specialist
209-004439
IL

Other

Enumeration date
08/30/2006
Last updated
11/27/2013
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