Individual
SREEKALA RADHAMANIAMMA DAVID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Contact information
Practice address
1061 WYNDGATE RIDGE DR, LAKE SAINT LOUIS, MO 63367-4354
(314) 256-9557
Mailing address
1061 WYNDGATE RIDGE DR, LAKE SAINT LOUIS, MO 63367-4354
(314) 556-4822
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041544395
IL
163W00000X
Registered Nurse
2010016856
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2026009953
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
209035395
IL
Other
Enumeration date
07/31/2023
Last updated
04/25/2026
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