Healthcare Provider Details

I. General information

NPI: 1063535581
Provider Name (Legal Business Name): ANNE CLAIR BISCH APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2007
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3165 MCKELVEY RD SUITE 110
BRIDGETON MO
63044-2550
US

IV. Provider business mailing address

6616 MARDEL AVE
SAINT LOUIS MO
63109-1226
US

V. Phone/Fax

Practice location:
  • Phone: 314-996-8943
  • Fax:
Mailing address:
  • Phone: 314-644-5278
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number113801
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: