CAROL BIVINS

SAINT LOUIS, MO
NPI1154935880
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: MO  2020028547)
Enumeration Date2020-09-01
Last Update Date2020-09-01
Business Address
CAROL BIVINS AG-NP
10012 KENNERLY RD
SAINT LOUIS, MO 63128-2042
Phone number: 314-543-5911
Mailing Address
CAROL BIVINS AG-NP
604 AUTUMN RISE LN
COLUMBIA, IL 62236-2867
Phone number: 414-412-8030