Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 2003022494 | MO |
NPI | 1033223961 |
---|---|
Provider Name | Krista L Lentine |
First Address | St Louis, MO 63110 |
Second Address | Saint Louis, MO 63110-2540 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/08/2006 |
Last Update Date | 25/03/2021 |