| NPI | 1699002527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LANEE MILLER Pediatric Nurse Practitioner 618-975-1607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 282NC2000X General Acute Care Hospital, Children (Licence: MO MO151383) |
| Enumeration Date | 2009-11-13 |
| Last Update Date | 2009-11-13 |