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General NPI Number Information
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NPI Number | 1245804491
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Entity Type | Organization
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Legal Business Name | ELLE BARBER LLC
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Dates
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Enumeration Date | 05/13/2021
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Last Update Date | 06/11/2021
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Provider Practice Location Address
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Address Line | 1 NORMTON DR
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2053
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Country | US
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Telephone | 314-537-0646
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Fax |
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Provider Business Mailing Address
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Address Line | 1 NORMTON DR
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City | SAINT LOUIS
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State | MO
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Zip | 63124-2053
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Country | US
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Telephone | 314-537-0646
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | ELLA BARBER
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Credential | PA-C
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Telephone | 314-537-0646
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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