AMANDA BERTHOLOMEY
Individual Provider (NPI-1)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1871103093- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 452 SOVEREIGN CT, BALLWIN, MO, 630114447
- Phone
- (636) 222-8699
Specialties & Taxonomies
Nurse Practitioner, Family
License: MO #2020026219
Nurse Practitioner, Family
Primary License: MO #2014018635