Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2004007025 | MO |
NPI | 1003058017 |
---|---|
Provider Name | Michelle L Piole |
First Address | Saint Louis, MO 63104-1003 |
Second Address | Maryland Heights, MO 63043-3411 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2009 |
Last Update Date | 12/01/2021 |