Blair A Theis
Nurse Practitioner - Pediatrics
35 Goodwin Dr
Festus
, Missouri 63028-4122
Blair A Theis
Nurse Practitioner - Pediatrics
35 Goodwin Dr
Festus
, Missouri 63028-4122
(636) 931-7007
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About
Features
Specialties
- Nurse Practitioner - Pediatrics
Languages spoken
- English
Location
First Address
- Blair A Theis
- 35 Goodwin Dr
- Festus, MO
- Zip : 63028-4122
- Fax : (636) 931-7007
- Phone : (636) 933-4141
Second Address
- Blair A Theis
- 35 Goodwin Dr
- Festus, MO
- Zip : 63028-4122
- Fax : (636) 931-7007
- Phone : (636) 933-4141
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2013035893 | MO |
National Provider Identifier
| NPI | 1013568120 |
|---|---|
| Provider Name | Blair A Theis |
| First Address | Festus, MO 63028-4122 |
| Second Address | Festus, MO 63028-4122 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/09/2019 |
| Last Update Date | 20/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.