Individual
STACEY YALE THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 N 11TH ST, SAINT LOUIS, MO 63101-1015
(314) 231-3720
Mailing address
184 HIGH ST STE 701, BOSTON, MA 02110-3025
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2023011764
MO
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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