Healthcare Provider Details

I. General information

NPI: 1972692283
Provider Name (Legal Business Name): ANGELA M SCHIEFELBEIN FNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3930 S BROADWAY
SAINT LOUIS MO
63118-4626
US

IV. Provider business mailing address

1717 BIDDLE ST
SAINT LOUIS MO
63106-3454
US

V. Phone/Fax

Practice location:
  • Phone: 314-814-8531
  • Fax: 314-814-8542
Mailing address:
  • Phone: 314-814-8531
  • Fax: 314-814-8542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number133058
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: