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Individual

KIA DANIELLE WASHINGTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
WHNP

Contact information

Practice address
440 E TAMPA ST, SPRINGFIELD, MO 65806-1131
(417) 831-0150
Mailing address
5471 DR MARTIN LUTHER KING DR, SAINT LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
2015044320
MO

Other

Enumeration date
02/29/2016
Last updated
10/15/2018
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