Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 2018042025 | MO |
NPI | 1346711843 |
---|---|
Provider Name | Lauren Michelle Hargis |
First Address | Saint Louis, MO 63130-2142 |
Second Address | Saint Louis, MO 63104-1003 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2018 |
Last Update Date | 12/11/2020 |