Mary Withoelter, Nurse Practitioner
Nurse Practitioner in Ofallon, MO. Individual provider (NPI-1).
NPI number1982188389
StatusActive
Last updated in NPPESSep 18, 2025
Details
- NPI
- 1982188389
- Entity type
- Individual (NPI-1)
- Name
- Mary Withoelter
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 20, 2018
- Certification date
- Sep 18, 2025
- Last updated
- Sep 18, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 2019033706 | MO | Yes |
| 363LF0000X | Nurse Practitioner, Family | 2019033706 | MO |
Practice location
2630 State Highway KOfallon, MO 63368
Phone 636-980-5300 · Fax 636-980-5344
Mailing address
Po Box 959354Saint Louis, MO 63195-9354
Phone 636-980-5300 · Fax 636-980-5344
Other practice locations
9556 Manchester Rd
Saint Louis, MO 63119-1313
Saint Louis, MO 63119-1313
Phone 314-373-5740
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