Healthcare Provider Details

I. General information

NPI: 1003479122
Provider Name (Legal Business Name): HAILEY NOELLE SCHLESINGER CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2019
Last Update Date: 03/26/2021
Certification Date: 03/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

621 S NEW BALLAS RD STE 63B
SAINT LOUIS MO
63141-8251
US

IV. Provider business mailing address

264 RIES RD
BALLWIN MO
63021-4900
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-0111
  • Fax:
Mailing address:
  • Phone: 314-966-0111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2019003448
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: