person
Mrs. Kongkeo Thiky Walther, ANP
Acute Care Nurse Practitioner in Bridgeton, Missouri
NPI 1528433430

Kongkeo Thiky Walther is an Acute Care Nurse Practitioner based in Chicago, MO and is specialized in Acute Care. Kongkeo Thiky Walther practices in Bridgeton, MO and has the professional credentials of ANP. The NPI Number for Kongkeo Thiky Walther is 1528433430 and holds a License No. 2015040094 (Missouri).

The current practice location address for Kongkeo Thiky Walther is 12774 Boenker Ln, Bridgeton, MO and can be reached out via phone at 314-291-7997 and via fax at 314-739-1471.

Location: 12774 Boenker Ln, Bridgeton, MO, 60677-6874
person
Provider Profile Details
NPI Number
1528433430
Provider Name
Kongkeo Thiky Walther
Credential
ANP
Provider Entity Type
Individual
Gender
Female
Address
12774 Boenker Ln, Bridgeton, MO, 60677-6874
Phone Number
314-291-7997
Fax Number
314-739-1471
Provider Enumeration Date
12/03/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
420030952 05 MO
institution
Provider Business Practice Location Address Details
Address
12774 Boenker Ln
City
State
Zip
63044-2436
Phone Number
314-291-7997
Fax Number
314-739-1471
person
Provider Business Mailing Address Details
Address
12774 Boenker Ln
City
State
Zip
63044-2436
Phone Number
314-291-7997
Fax Number
314-739-1471
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Acute Care
Taxonomy
License No.
2015040094 (Missouri)
Definition
Definition to come...
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