MADELINE JANE DISTLER AGACNP NPI 1053911297

NPI Information

NPI: 1053911297
Provider Name: MADELINE JANE DISTLER, AGACNP
Classification: Nurse Practitioner - 363LC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Address:
4590 CHILDRENS PL STOP 90-29916
SAINT LOUIS, MO
ZIP 63110
Phone: (314) 273-3194
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Madeline Jane Distler, AGACNP is a critical care medicine nurse practitioner in Saint Louis, MO. Madeline Jane Distler, AGACNP NPI is 1053911297. 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:

4590 CHILDRENS PL STOP 90-29916
SAINT LOUIS, MO
ZIP 63110-020
Phone: (314) 273-3194

The enumeration date for this NPI number is 10/27/2020 and was last updated on 10/27/2020.

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	363LC0200X	Nurse Practitioner	Critical Care Medicine	2020012267	MISSOURI	Yes

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: 11/14/2023

NPI Synchronization or Removal

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