Individual
KATHLEEN NOLAN DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
615 S NEW BALLAS RD STE 1200, SAINT LOUIS, MO 63141-8221
(314) 251-2880
Mailing address
3449 MACKLIND AVE, SAINT LOUIS, MO 63139-1562
(501) 765-5288
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2021023487
MO
Other
Enumeration date
03/08/2021
Last updated
12/02/2022
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