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General NPI Number Information
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NPI Number | 1699552547
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Entity Type | Individual
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Provider Name | MARISA CHRISTOPHER PA-C
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Gender | Female
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 300 MEDICAL PLZ STE 310
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1484
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Country | US
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Telephone | 636-625-2662
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Fax |
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Provider Business Mailing Address
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Address Line | 125 E PINE ST APT 2215
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City | ORLANDO
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State | FL
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Zip | 32801-3099
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Country | US
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Telephone | 636-544-8000
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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