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General NPI Number Information
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NPI Number | 1639209745
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Entity Type | Individual
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Provider Name | JULIE MAY STOUT ANP-BC
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Gender | Female
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Dates
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Enumeration Date | 03/07/2007
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Last Update Date | 03/23/2023
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Provider Practice Location Address
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Address Line | 15945 CLAYTON RD STE 310
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City | BALLWIN
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State | MO
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Zip | 63011-2493
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Country | US
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Telephone | 636-863-1356
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Fax | 636-893-1358
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Provider Business Mailing Address
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Address Line | 6 SILVER LN
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City | KIRKWOOD
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State | MO
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Zip | 63122-5819
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Country | US
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Telephone | 314-278-6712
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 086973
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License Number State | MO
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