Healthcare Provider Details

I. General information

NPI: 1881835551
Provider Name (Legal Business Name): LINDA STIERS DAAKE RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2009
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 OFFICE PKWY
SAINT LOUIS MO
63141-7105
US

IV. Provider business mailing address

760 OFFICE PKWY
SAINT LOUIS MO
63141-7105
US

V. Phone/Fax

Practice location:
  • Phone: 314-995-4700
  • Fax: 314-995-4701
Mailing address:
  • Phone: 314-995-4700
  • Fax: 314-995-4701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License Number073513
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: