Individual
STEPHANIE ANN SOURIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Mailing address
555 WASHINGTON SQUARE SHOPPING CTR, WASHINGTON, MO 63090-5343
(636) 390-1777
(636) 390-1778
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018027615
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018027615
AANP
MO
Enumeration date
08/07/2018
Last updated
03/21/2022
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