Healthcare Provider Details

I. General information

NPI: 1144002593
Provider Name (Legal Business Name): AMANDA FERRELL STRATMANN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/19/2023
Last Update Date: 10/25/2023
Certification Date: 10/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE CHIDREN'S PLACE
ST. LOUIS MO
63110
US

IV. Provider business mailing address

ONE CHILDREN'S PLACE NICU
ST. LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0000X
TaxonomyNeonatal Nurse Practitioner
License Number104168655
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: