Individual
SHAFONNE MONIQUE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP-BC
Contact information
Practice address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-7631
Mailing address
401 HOLLY HILLS AVE, SAINT LOUIS, MO 63111-2410
(314) 353-5190
(314) 353-7631
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
2024011653
MO
363LA2200X
Adult Health Nurse Practitioner
Primary
2016009888
MO
363LG0600X
Gerontology Nurse Practitioner
2016009888
MO
363LW0102X
Women's Health Nurse Practitioner
28208566A
IN
Other
Enumeration date
05/08/2013
Last updated
09/30/2024
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