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1104394899
CHRISTINA MARIE IVY
O FALLON, MO
NPI
1104394899
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: MO 2018040232)
Enumeration Date
2018-11-12
Last Update Date
2018-11-12
Business Address
Mrs. CHRISTINA MARIE IVY FNP-C
2765 RED CEDAR PARC DR S
O FALLON, MO 63368-6609
Phone number: 636-248-8072
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Mailing Address
Mrs. CHRISTINA MARIE IVY FNP-C
2765 RED CEDAR PARC DR S
O FALLON, MO 63368-6609
Phone number: 636-248-8072
Copy
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