Provider Demographics
NPI:1649984683
Name:WAMBUI, ANNE (RN)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:
Last Name:WAMBUI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5786 WESTPHALIA LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63129-4114
Mailing Address - Country:US
Mailing Address - Phone:314-585-3023
Mailing Address - Fax:
Practice Address - Street 1:5786 WESTPHALIA LN
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63129-4114
Practice Address - Country:US
Practice Address - Phone:314-585-3023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-12
Last Update Date:2023-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015011245163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty