Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | F07171048 | MO |
NPI | 1003326711 |
---|---|
Provider Name | Mrs. Elizabeth Ann Curtis |
First Address | Saint Louis, MO 63119-4312 |
Second Address | Chesterfield, MO 63017-2004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2017 |
Last Update Date | 21/05/2020 |