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General NPI Number Information
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NPI Number | 1497485395
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Entity Type | Organization
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Legal Business Name | STL MOBILE HEALTH CARE
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Dates
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Enumeration Date | 06/14/2022
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 111 W PORT PLZ STE 600
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3015
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Country | US
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Telephone | 618-335-2478
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Fax |
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Provider Business Mailing Address
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Address Line | 111 W PORT PLZ STE 600
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City | SAINT LOUIS
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State | MO
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Zip | 63146-3015
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Country | US
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Telephone | 618-335-2478
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Fax | 636-333-4510
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Authorized Official
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Title or Position | CEO
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Name | LEANN NITZ
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Credential | NP
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Telephone | 618-335-2478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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