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1417354440
CASSANDRA MARIE WALLACE
SAINT LOUIS, MO
NPI
1417354440
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LP0200X Nurse Practitioner, Pediatrics
(Licence: MO 2014038394)
Enumeration Date
2014-11-19
Last Update Date
2024-08-27
Business Address
Ms. CASSANDRA MARIE WALLACE PNP
1 CHILDRENS PL
SAINT LOUIS, MO 63110-1002
Phone number: 314-362-1408
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Mailing Address
Ms. CASSANDRA MARIE WALLACE PNP
1 CHILDRENS PL
SAINT LOUIS, MO 63110-1002
Phone number: 314-454-2341
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