Healthcare Provider Details

I. General information

NPI: 1710125497
Provider Name (Legal Business Name): DEBRA L FOERSTERLING ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 KENNERLY RD
SAINT LOUIS MO
63128-2106
US

IV. Provider business mailing address

PO BOX 504683
SAINT LOUIS MO
63150-4683
US

V. Phone/Fax

Practice location:
  • Phone: 314-525-1000
  • Fax: 636-333-4510
Mailing address:
  • Phone: 636-333-4500
  • Fax: 636-333-4510

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number082852
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: