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General NPI Number Information
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NPI Number | 1801087481
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Entity Type | Organization
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Legal Business Name | RADIANT WOMEN'S HEALTH, P.C.
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Dates
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Enumeration Date | 08/07/2007
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Last Update Date | 08/07/2007
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Provider Practice Location Address
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Address Line | 400 1ST CAPITOL DR SUITE 301
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2880
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Country | US
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Telephone | 636-255-3003
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Fax | 636-925-0954
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Provider Business Mailing Address
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Address Line | 400 1ST CAPITOL DR SUITE 301
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City | SAINT CHARLES
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State | MO
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Zip | 63301-2880
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Country | US
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Telephone | 636-255-3003
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Fax | 636-925-0954
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. VALERIE KIM NELSON-MASON
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Credential | M.D.
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Telephone | 636-255-3003
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 2005000368
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License Number State | MO
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