MEDICARE: LAUREN POHLE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2021003410	MO

General Provider Information

NPI Number	:	1033707344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN POHLE

Provider Business Mailing Address
First Line	:	10334 MANCHESTER RD
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63122-1521
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10334 MANCHESTER RD
Second Line	:
City	:	KIRKWOOD
State	:	MO
Zip	:	63122-1521
Country	:	US
Telephone Number	:	314-369-2897
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2021
Last Update Date	:	09/02/2021

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Directions to “ LAUREN POHLE ” Practice Location

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