Individual
PANGAA FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
(314) 251-4564
Mailing address
615 S NEW BALLAS RD, SAINT LOUIS, MO 63141-8221
(314) 251-6339
(314) 251-4564
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019015720
MO
363LF0000X
Family Nurse Practitioner
R0120309
OK
Other
Enumeration date
10/16/2016
Last updated
05/21/2025
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