Individual
CHARLES JONAH MCCLOSKEY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4200
Mailing address
5341 NEOSHO ST, SAINT LOUIS, MO 63109-2958
(314) 766-5309
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2021042424
MO
363LF0000X
Family Nurse Practitioner
Primary
2021042424
MO
Other
Enumeration date
10/28/2021
Last updated
10/28/2021
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