Most Relevant Information
Provider Data
| NPI Number: | 1003309147 |
| Provider Name: | MARY BETH WALKER FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 2018013788 |
Most Important Dates
| Enumeration Date: | 06/13/2018 |
| Last Updated: | 06/13/2018 |
Provider Practice Location
615 S NEW BALLAS RD
SAINT LOUIS
MO
631418221
Practice Location Phone/Fax
| Phone: | 3142516000 |
| Fax: |
Provider Mailing Location
615 S NEW BALLAS RD
SAINT LOUIS
MO
631418221
Provider Mailing Phone/Fax
| Phone: | 3142516000 |
| Fax: |