Individual
NICKOLAS RONGEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP-C
Contact information
Practice address
3550 MCKELVEY RD, BRIDGETON, MO 63044-2527
(314) 741-0911
(314) 741-0501
Mailing address
128 CARRIAGE HOUSE LN, SAINT PETERS, MO 63376-6800
(636) 484-3170
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2018040228
MO
363L00000X
Nurse Practitioner
209020503
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420066868
—
MO
Enumeration date
02/14/2019
Last updated
12/06/2021
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