MEDICARE: MRS. AMY ELIZABETH SEIPEL AGNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	2014027285	MO
2	363L00000X	Nurse Practitioner	2014027285	MO

General Provider Information

NPI Number	:	1295110229
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY ELIZABETH SEIPEL AGNP-C

Provider Business Mailing Address
First Line	:	425 N NEW BALLAS RD STE 230
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6848
Country	:	US
Telephone Number	:	314-266-2066
Fax Number	:	314-266-2069

Provider Business Practice Location Address
First Line	:	425 N NEW BALLAS RD STE 230
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63141-6848
Country	:	US
Telephone Number	:	314-266-2066
Fax Number	:	314-266-2069

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/20/2015
Last Update Date	:	09/15/2022

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