Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | 2008035924 | MO |
Y | 363LP0200X | Nurse Practitioner - Pediatrics | 2008035924 | MO |
NPI | 1013241686 |
---|---|
Provider Name | Ms. Caroline Elizabeth Mohrmann |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Saint Louis, MO 63110-1002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2009 |
Last Update Date | 15/11/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
426469003 | (05) | MO |