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Individual

MS. ELIZABETH ANNE NIEDERSCHULTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
1020 N MASON RD, DIV IM CARDIOLOGY, STE 100, SAINT LOUIS, MO 63141-6666
(314) 362-1291
(314) 996-3268
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1291
(314) 996-3268

Taxonomy

Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2018039908
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420079628
MO
Enumeration date
12/03/2018
Last updated
04/17/2025
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