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General NPI Number Information
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NPI Number | 1073618021
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Entity Type | Individual
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Provider Name | MONICA WASHBURN
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Gender | Female
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 01/16/2023
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Provider Practice Location Address
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Address Line | 1603 WENTZVILLE PKWY
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City | WENTZVILLE
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State | MO
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Zip | 63385-3826
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Country | US
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Telephone | 844-776-7200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 955534
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City | SAINT LOUIS
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State | MO
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Zip | 63195-0001
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 146772
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 146772
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License Number State | MO
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