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Individual

PENNIE DENISE CLINTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6121 N HANLEY RD, SAINT LOUIS, MO 63134-2003
(314) 679-7880
Mailing address
6121 N HANLEY RD, SAINT LOUIS, MO 63134-2003

Taxonomy

Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
2009006104
MO

Other

Enumeration date
03/04/2013
Last updated
03/04/2013
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