Individual
MS. MARY J CAMPIGOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-6034
(314) 454-2876
Mailing address
660 S EUCLID AVE, CB 8242, SAINT LOUIS, MO 63110-1010
(314) 454-6034
(314) 454-2876
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111597
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427176904
—
MO
05
—
ENROLLED
—
IL
Enumeration date
07/17/2006
Last updated
06/13/2019
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