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1104101872
TANIKA JOI PROWELL
SAINT LOUIS, MO
NPI
1104101872
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163W00000X Registered Nurse
(Licence: MO 2006007421)
Enumeration Date
2011-10-13
Last Update Date
2011-10-13
Business Address
Miss TANIKA JOI PROWELL RN
4000 JENNINGS STATION RD
SAINT LOUIS, MO 63121-3323
Phone number: 314-679-7880
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Mailing Address
Miss TANIKA JOI PROWELL RN
111 S MERAMEC AVE 41 S CENTRAL AVE
CLAYTON, MO 63105-1711
Phone number: 314-615-0600
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