Organization
HEALTHWISE ADVANCED PRACTICE PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAQUITA DANIELLE LEWIS ACNP-BC (OWNER)
(314) 624-1317
Entity
Organization
Contact information
Practice address
3490 HOLLENBERG DR, BRIDGETON, MO 63044-2429
(314) 500-0716
(314) 463-0755
Mailing address
14472 WILLIAMSBURG MANOR DR, FLORISSANT, MO 63034-1753
(314) 479-6473
(314) 463-0755
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101740097
—
MO
01
—
1669743241
NPI
MO
Enumeration date
08/11/2022
Last updated
08/11/2022
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