Individual
MICHELE C MARCUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3844 S LINDBERGH BLVD, STE 120, SAINT LOUIS, MO 63127-1368
(314) 525-0490
(314) 525-0434
Mailing address
670 MASON RIDGE CENTER DR, STE 300, SAINT LOUIS, MO 63141-8573
(314) 525-0490
(314) 525-0434
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011001347
MO
363LG0600X
Gerontology Nurse Practitioner
104267
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429078108
—
MO
Enumeration date
03/31/2006
Last updated
04/11/2017
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