Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 2020037592 | MO |
NPI | 1053906487 |
---|---|
Provider Name | Ms. Christine Frances Kuehnel |
First Address | Saint Louis, MO 63110-1010 |
Second Address | Saint Louis, MO 63136-6150 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2021 |
Last Update Date | 15/11/2021 |