Individual
SANDRA R. HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
2900 LEMAY FERRY RD, STE 104, SAINT LOUIS, MO 63125-3900
(314) 525-1887
(314) 525-1868
Mailing address
2900 LEMAY FERRY RD, STE 104, SAINT LOUIS, MO 63125-3900
(314) 525-1887
(314) 525-1868
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
104685
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427423306
—
MO
Enumeration date
10/25/2006
Last updated
03/14/2017
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