Healthcare Provider Details

I. General information

NPI: 1144853193
Provider Name (Legal Business Name): EMILY RIETH BUHMAN AGNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/18/2020
Last Update Date: 04/15/2025
Certification Date: 07/05/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11133 DUNN RD DIV IM MEDICAL ONCOLOGY
SAINT LOUIS MO
63136-6163
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 800-647-2098
  • Fax: 314-362-3192
Mailing address:
  • Phone: 800-647-2098
  • Fax: 314-362-3192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number2020005619
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: