Provider Demographics
NPI:1407384902
Name:MUNTER, ALEXIA MARIE (NP)
Entity Type:Individual
Prefix:MRS
First Name:ALEXIA
Middle Name:MARIE
Last Name:MUNTER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:456 N NEW BALLAS RD STE 129
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6812
Mailing Address - Country:US
Mailing Address - Phone:314-569-1881
Mailing Address - Fax:314-569-3277
Practice Address - Street 1:456 N NEW BALLAS RD STE 129
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6812
Practice Address - Country:US
Practice Address - Phone:314-569-1881
Practice Address - Fax:314-569-3277
Is Sole Proprietor?:No
Enumeration Date:2017-05-27
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017006575363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily