Individual
MS. DOLORES JEANNINE ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5471 DR MARTIN LUTHER KING DRIVE, ST LOUIS, MO 63112-4265
(314) 367-5820
Mailing address
5471 DR MARTIN LUTHER KING DRIVE, ST LOUIS, MO 63112-4265
(314) 367-5820
(314) 367-7010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2007018599
MO
Other
Enumeration date
09/19/2007
Last updated
09/19/2007
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