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Individual

MS. MARISSA LEIGH SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
1600 S BRENTWOOD BLVD, DIV NEUROLOGY SLEEP MED, STE 600, SAINT LOUIS, MO 63144-1320
(314) 362-1408
(314) 747-4342
Mailing address
660 S EUCLID AVE, CB 8111, SAINT LOUIS, MO 63110-1010
(314) 362-4342
(314) 747-3813

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2021009802
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
420097107
MO
Enumeration date
09/18/2014
Last updated
11/15/2021
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