Individual
LAURETTA PEARSON WEGMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
400 MEDICAL PLZ STE 10, LAKE ST LOUIS, MO 63367-1432
(636) 625-6052
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2021026157
MO
Other
Enumeration date
08/05/2021
Last updated
12/18/2024
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