Individual
DR. CAROLINE GRACE NUGENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16555 MANCHESTER RD STE 201, WILDWOOD, MO 63040-1220
(636) 458-5858
(636) 458-6510
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(636) 458-5858
(636) 458-6510
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2021042916
MO
208M00000X
Hospitalist Physician
Primary
2021042916
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200083457
—
MO
Enumeration date
07/09/2020
Last updated
06/05/2024
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