Individual
MRS. NICHOLE MICHELLE BAUMGARTNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 807-3105
Mailing address
6 PAR CT, HIGH RIDGE, MO 63049-3526
(314) 807-3105
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F06192192
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Enumeration date
05/30/2019
Last updated
07/23/2019
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