Individual
LISA DALE HENRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 454-2477
(314) 454-4595
Mailing address
270 RIDGE TRAIL DR, CHESTERFIELD, MO 63017-3030
(314) 454-2477
(314) 454-4595
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
107570
MO
Other
Enumeration date
04/11/2007
Last updated
05/18/2022
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