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1154935880
CAROL BIVINS
SAINT LOUIS, MO
NPI
1154935880
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LA2200X Nurse Practitioner Adult Health
(Licence: MO 2020028547)
Enumeration Date
2020-09-01
Last Update Date
2020-09-01
Business Address
CAROL BIVINS AG-NP
10012 KENNERLY RD
SAINT LOUIS, MO 63128-2042
Phone number: 314-543-5911
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Mailing Address
CAROL BIVINS AG-NP
604 AUTUMN RISE LN
COLUMBIA, IL 62236-2867
Phone number: 414-412-8030
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