Individual
KATHY LIEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
4600 MEMORIAL DR STE 120, BELLEVILLE, IL 62226-5359
(618) 222-1020
(618) 222-1039
Mailing address
PO BOX 959203, SAINT LOUIS, MO 63195-9203
(618) 222-1020
(618) 222-1039
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209015891
IL
363LF0000X
Family Nurse Practitioner
209015891
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209015891
APN LICENSE
IL
Enumeration date
07/13/2017
Last updated
12/24/2025
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