MS. ELIZABETH ANNE NIEDERSCHULTE AGNP NPI 1679043665

NPI Information

NPI: 1679043665
Provider Name: MS. ELIZABETH ANNE NIEDERSCHULTE, AGNP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

PECOS Registration: Yes

Address:
1020 N MASON RD
DIV IM CARDIOLOGY, STE 100
SAINT LOUIS, MO
ZIP 63141
Phone: (314) 362-1291
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MS. Elizabeth Anne Niederschulte, AGNP is a gerontology nurse practitioner in Saint Louis, MO with 6 years of experience. MS. Elizabeth Anne Niederschulte, AGNP NPI is 1679043665. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1020 N MASON RD
DIV IM CARDIOLOGY, STE 100
SAINT LOUIS, MO
ZIP 63141-666
Phone: (314) 362-1291
Fax: (314) 996-3268

The NPI 1679043665 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/3/2018 and was last updated on 4/25/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LG0600X	Nurse Practitioner	Gerontology	2018039908	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	420079628	MEDICAID	MISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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