Healthcare Provider Details

I. General information

NPI: 1033709886
Provider Name (Legal Business Name): LAUREN ELIZABETH HUFF FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/25/2021
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 S NEW BALLAS RD STE 2015
SAINT LOUIS MO
63141-8253
US

IV. Provider business mailing address

625 S NEW BALLAS RD STE 2015
SAINT LOUIS MO
63141-8253
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-1700
  • Fax:
Mailing address:
  • Phone: 314-251-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2021019790
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: