Individual
EMILY CIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
625 S NEW BALLAS RD STE 7063, SAINT LOUIS, MO 63141-8218
(314) 251-4200
Mailing address
625 S NEW BALLAS RD STE 7063, SAINT LOUIS, MO 63141-8218
(314) 251-4200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
4609
TN
363AS0400X
Surgical Physician Assistant
Primary
2021012355
MO
363AS0400X
Surgical Physician Assistant
4609
TN
Other
Enumeration date
03/31/2020
Last updated
01/04/2023
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