Individual
ELIZABETH BOKERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
12349 DE PAUL DR STE 100, BRIDGETON, MO 63044-2512
(314) 291-7900
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2015008953
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015008953
LICENSE
MO
Enumeration date
04/01/2015
Last updated
11/19/2020
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