Healthcare Provider Details

I. General information

NPI: 1144720558
Provider Name (Legal Business Name): ASHLEIGH NICHOLE WESSELSCHMIDT ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2018
Last Update Date: 04/17/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5225 MID AMERICA PLZ DIV IM MEDICAL ONCOLOGY, STE D115
SAINT LOUIS MO
63129-0002
US

IV. Provider business mailing address

PO BOX 7412011
CHICAGO IL
60674-2011
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-2500
  • Fax: 314-362-7086
Mailing address:
  • Phone: 314-286-2500
  • Fax: 314-362-7086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2018004208
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: