Individual
MARTHA KERUBO OMBOGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
12272 CREVE COEUR RIDGE CT, MARYLAND HEIGHTS, MO 63043-1213
(816) 824-1447
Mailing address
12272 CREVE COEUR RIDGE CT, MARYLAND HEIGHTS, MO 63043-1213
(816) 824-1447
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2022012281
MO
Other
Enumeration date
04/06/2022
Last updated
04/06/2022
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