Healthcare Provider Details

I. General information

NPI: 1477697746
Provider Name (Legal Business Name): LAURA E. ROMER APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2007
Last Update Date: 09/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4219 LACLEDE AVE SUITE B
SAINT LOUIS MO
63108-2814
US

IV. Provider business mailing address

4219 LACLEDE AVE SUITE B
SAINT LOUIS MO
63108-2814
US

V. Phone/Fax

Practice location:
  • Phone: 314-286-4545
  • Fax: 314-286-4542
Mailing address:
  • Phone: 314-286-4545
  • Fax: 314-286-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number090161
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: