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Individual

MS. MEREDITH A WALTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ADT NURSING PRAC ANP

Contact information

Practice address
10012 KENNERLY RD, SUITE 301, SAINT LOUIS, MO 63128-2197
(314) 729-0088
(314) 729-0088
Mailing address
10012 KENNERLY RD, SUITE 301, SAINT LOUIS, MO 63128-2197
(314) 729-0088
(314) 729-0088

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
041301761
IL
363L00000X
Nurse Practitioner
146250
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
04232002
BCBS
IL
01
072357
EXCLUSIVE CHOICE
MO
05
427262704
MO
01
711678
HEALTHLINK
MO
01
7260711
AETNA
MO
01
SA56538
HEALTHCARE USA
MO
Enumeration date
06/02/2006
Last updated
04/16/2010
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