Individual
MARGARET HENNESSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3635 VISTA AVE, SAINT LOUIS, MO 63110-2539
(314) 577-8000
Mailing address
360 RIETH TER, KIRKWOOD, MO 63122-3517
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1147530
NCCPA
—
Enumeration date
10/24/2017
Last updated
10/24/2017
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