Individual
KATHLEEN L FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BC, ANP
Contact information
Practice address
10012 KENNERLY RD, SUITE 204, SAINT LOUIS, MO 63128-2197
(314) 525-1220
(314) 842-9952
Mailing address
10012 KENNERLY RD, SUITE 204, SAINT LOUIS, MO 63128-2197
(314) 525-1220
(314) 842-9952
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
086013
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427628102
—
MO
Enumeration date
10/12/2005
Last updated
05/13/2014
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