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Contact Information

ADVANCED FAMILY MEDICINE, LLC
777 S NEW BALLAS RD
STE 100E
SAINT LOUIS, MO63141-8705
 Phone: 803-788-5916
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for ADVANCED FAMILY MEDICINE LLC · (Female)

NPI Number 1205290749
Status Active
Credentials
Entity Individual
Enumeration date 04/11/2016
Last updated 04/11/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • MO License # 144077
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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