Healthcare Provider Details

I. General information

NPI: 1619027695
Provider Name (Legal Business Name): DORCAS ELISABETH MCLAUGHLIN PHD, APRN, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8420 DELMAR BLVD. SUITE 202
ST. LOUIS MO
63124-2109
US

IV. Provider business mailing address

8420 DELMAR BLVD. SUITE 202
ST. LOUIS MO
63124-2109
US

V. Phone/Fax

Practice location:
  • Phone: 314-307-6648
  • Fax: 636-530-7552
Mailing address:
  • Phone: 314-307-6648
  • Fax: 636-530-7552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number054789
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: