Individual
LISA SELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
800 N TUCKER BLVD, SAINT LOUIS, MO 63101-1008
(224) 505-3279
Mailing address
800 N TUCKER BLVD, SAINT LOUIS, MO 63101-1008
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2018038899
MO
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
02/21/2020
Last updated
02/24/2020
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