Unknown Individual – Licensed Practical Nurse, NPI 1760536288
Licensed Practical Nurse
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
5471, Doctor Martin Luther King Drive, Wells Goodfellow, Cabanne Place, City of Saint Louis, Missouri, 63112, United States
ST LOUIS, MO 631124265
Phone: (314) 367-5820
Fax: (314) 367-7010
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 63112)
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