Individual
LINGXIAO LU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6663
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6663
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2021028732
MO
363LG0600X
Gerontology Nurse Practitioner
28220633A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300005862
—
IN
01
—
M47140291
MEDICARE
IN
Enumeration date
06/30/2017
Last updated
08/25/2021
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