Individual
DEANA ISSAWI
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) 251-6000
Mailing address
9616 ANTIGO DR, SAINT LOUIS, MO 63123-7106
(314) 540-9142
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015024695
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Enumeration date
06/17/2022
Last updated
07/05/2022
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