Healthcare Provider Details

I. General information

NPI: 1780380063
Provider Name (Legal Business Name): ALEXANDRA SIGMUND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16117 CASTLEREA BLVD
ELLISVILLE MO
63021-4512
US

IV. Provider business mailing address

16117 CASTLEREA BLVD
ELLISVILLE MO
63021-4512
US

V. Phone/Fax

Practice location:
  • Phone: 636-222-8171
  • Fax:
Mailing address:
  • Phone: 636-222-8171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: