Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | 2012028452 | MO |
NPI | 1134477177 |
---|---|
Provider Name | Mrs. Lisa M Schuller |
First Address | Saint Peters, MO 63376-7758 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2012 |
Last Update Date | 23/08/2012 |