Individual
SASI VINJAMOORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC, FNP
Contact information
Practice address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 317-0600
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
128972
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801861497
—
IL
05
—
425221314
—
MO
Enumeration date
02/17/2006
Last updated
12/02/2020
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