Search › Missouri › 363LA2100X
Kongkeo Walther, ANP
NPI 1528433430 · on the registry since 2015
Practice
- Address
- 12774 Boenker Ln
Bridgeton, MO 63044 - Phone
- (314) 291-7997
- Fax
- (314) 739-1471
- Organisation at this address
- Northwest Infectious Disease Services Llc
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 8
Additional practice sites
- 4921 Parkview Pl, Saint Louis, MO
Registry record
- Primary taxonomy
- 363LA2100X
363LA2100X
- Licence states on file
- MO
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2023-12-21
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