Individual
MR. EDWARD JIM VREDENBURGH III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
11133 DUNN RD, SAINT LOUIS, MO 63136-6163
(314) 653-5000
Mailing address
11133 DUNN RD, SAINT LOUIS, MO 63136-6163
(314) 653-5000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2001004428
MO
363LF0000X
Family Nurse Practitioner
Primary
2018037132
MO
Other
Enumeration date
10/22/2016
Last updated
06/28/2023
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