KATY HELENE WINE

SHILOH, IL
NPI1174150726
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: IL  209018627)
Additional Taxonomies363L00000X Nurse Practitioner
(Licence: MO  2019001390)
363LF0000X Nurse Practitioner, Family
(Licence: MO  2019001390)
Enumeration Date2020-03-24
Last Update Date2024-04-10
Business Address
KATY HELENE WINE MSN, FNP-C
1414 CROSS ST STE 240
SHILOH, IL 62269-2941
Phone number: 618-234-2390
Mailing Address
KATY HELENE WINE MSN, FNP-C
660 MASON RIDGE CENTER DR STE 300
SAINT LOUIS, MO 63141-8512
Phone number: 314-448-3791