Individual
MICAH SCHENCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12200 WEBER HILL RD STE 100, SAINT LOUIS, MO 63127-1569
(314) 698-2500
Mailing address
2306 VIMINAL CT, FENTON, MO 63026-2223
(314) 809-1512
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2017035413
MO
363LP2300X
Primary Care Nurse Practitioner
Primary
2023023144
MO
Other
Enumeration date
05/29/2023
Last updated
06/17/2023
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