NPI 1083230924

Malinda a Phenix

Practitioner Nurse's Aide Saint Louis, MO

Practice location

Address: 5819 Hodiamont Ave, Saint Louis, MO 63136-3601
Phone: (314) 757-1191

Registered specialties

Nurse's Aide Primary

Nursing Service Related Providers Taxonomy 376K00000X Licence 20151139 (MO)

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Registry record

NPI: 1083230924
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 Jun 2020
Record last updated: 16 Jun 2020

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.