Organization
ADVANCED ICU CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ISABELLE KOPEC M.D (V.P. MEDICAL AFFAIRS)
(314) 514-6000
Entity
Organization
Contact information
Practice address
999 EXECUTIVE PARKWAY DR, STE 210, SAINT LOUIS, MO 63141-6336
(314) 514-6000
Mailing address
16444 WESTKNOLL CV, CHESTERFIELD, MO 63017-4668
(414) 331-0089
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
2009009197
WI
Other
Enumeration date
12/23/2009
Last updated
12/23/2009
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