Individual
TISA SUZANNE AYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
Mailing address
230 NORMANDIE DR, BONNE TERRE, MO 63628-9215
(573) 701-8408
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2021001577
MO
Other
Enumeration date
01/15/2021
Last updated
09/12/2022
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