Individual
LYLY DANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
11560 OLIVE BLVD, CREVE COEUR, MO 63141-7111
(314) 995-7128
Mailing address
11560 OLIVE BLVD, CREVE COEUR, MO 63141-7111
(314) 995-7128
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019036142
MO
Other
Enumeration date
02/17/2020
Last updated
05/28/2022
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