Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 2022004504 | MO |
NPI | 1487313987 |
---|---|
Provider Name | Dr. Molly Katherine Eggleston |
First Address | Saint Louis, MO 63122-1105 |
Second Address | Saint Louis, MO 63141-8221 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/12/2021 |
Last Update Date | 07/02/2022 |