Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 2019024736 | MO |
NPI | 1013569532 |
---|---|
Provider Name | Sarah Elizabeth Lednick |
First Address | Saint Peters, MO 63376-1601 |
Second Address | Weldon Spring, MO 63304-9101 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2019 |
Last Update Date | 03/11/2021 |