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Search › Missouri › 164W00000X

Angela Pettis, LPN

NPI 1053056143 · on the registry since 2022

Practice

Address
1 Meramec Bluffs Dr
Ballwin, MO 63021
Phone
(636) 923-2399
Organisation at this address
Lutheran Senior Services
Theodore K Sullivan, Od, Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
14

Registry record

Primary taxonomy
164W00000X
164W00000X
Licence states on file
MO
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2022-05-03

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Missouri