Individual
KATHERINE BLEISCH
Active
Individual
KATHERINE BLEISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2016000966
MO
363LG0600X
Gerontology Nurse Practitioner
2016000966
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
46-2913068
—
MO
Enumeration date
01/18/2016
Last updated
01/18/2016
Update your record
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