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General NPI Number Information
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NPI Number | 1295424869
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Entity Type | Organization
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Legal Business Name | STAYHOME MEDICAL LLC
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Dates
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Enumeration Date | 05/01/2023
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Last Update Date | 05/01/2023
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Provider Practice Location Address
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Address Line | 192 GREENTRAILS DR N
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2552
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Country | US
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Telephone | 314-944-3003
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Fax | 314-735-4311
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Provider Business Mailing Address
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Address Line | 192 GREENTRAILS DR N
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2552
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Country | US
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Telephone | 314-944-3003
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Fax | 314-735-4311
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Authorized Official
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Title or Position | CEO, FNP
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Name | ADINA WINTER
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Credential | NP
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Telephone | 314-944-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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