Healthcare Provider Details
I. General information
NPI: 1871640540
Provider Name (Legal Business Name): ST. LOUIS FIRST ASSISTANTS,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/04/2007
Last Update Date: 05/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
405 SAVANNAH RIDGE DR
SAINT CHARLES MO
63303-2918
US
IV. Provider business mailing address
405 SAVANNAH RIDGE DR
SAINT CHARLES MO
63303-2918
US
V. Phone/Fax
- Phone: 636-244-0704
- Fax: 636-244-0704
- Phone: 636-244-0704
- Fax: 636-244-0704
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WR0006X |
| Taxonomy | Registered Nurse First Assistant |
| License Number | 071376 |
| License Number State | MO |
VIII. Authorized Official
Name: MR.
RICHARD
A
FIEHLER
Title or Position: PRESIDENT
Credential:
Phone: 636-244-0704