Healthcare Provider Details

I. General information

NPI: 1982907325
Provider Name (Legal Business Name): ANN MICHELLE LEHRER ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2010
Last Update Date: 12/10/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-8306
  • Fax: 314-257-2017
Mailing address:
  • Phone: 314-577-8306
  • Fax: 314-257-2017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number154649
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: