Healthcare Provider Details

I. General information

NPI: 1952560260
Provider Name (Legal Business Name): DIANNA J. OHLMAN NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2008
Last Update Date: 02/25/2021
Certification Date: 02/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 BJC SAINT PETERS DR STE 200
SAINT PETERS MO
63376-3385
US

IV. Provider business mailing address

201 BJC SAINT PETERS DR STE 200
SAINT PETERS MO
63376-3386
US

V. Phone/Fax

Practice location:
  • Phone: 636-916-9615
  • Fax: 636-916-9850
Mailing address:
  • Phone: 636-916-9615
  • Fax: 636-916-9850

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number124223
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: