Individual
MS. LISA MARIE ROELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1 CHILDRENS PL, DIV PED CARDIOLOGY, SAINT LOUIS, MO 63110-1002
(314) 454-6095
(314) 884-6008
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 454-6095
(314) 884-6008
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2017037108
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
220066622
—
MO
Enumeration date
04/06/2009
Last updated
02/09/2026
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