MS. LISA A KOESTER-WIEDEMANN


Address: 4950 Childrens Pl, Saint Louis, MO 63110-1000
Phone: 3143627268

MS. LISA A KOESTER-WIEDEMANN (NPI# 1184642662) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184642662
Entity Type Individual
Full Name MS. LISA A KOESTER-WIEDEMANN
Credential ANP
Practice Address 4950 Childrens Pl
Saint Louis
MO 63110-1000
Mailing Address 660 S Euclid Ave
C B 8126
Saint Louis
MO 63110-1010
Practice Telephone 3143627268
Practice Fax Number 3147473743
Mailing Telephone 3142860801
Mailing Fax Number 3142860855
Enumeration Date 2006-07-17
Last Update Date 2018-01-24
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LA2200X Nurse Practitioner
Specialization: Adult Health
134512 MO Physician Assistants & Advanced Practice Nursing Providers

Other Provider Identifier

State Issuer Identifier Type Code
MO 425146008 05
IL ENROLLED 05

Office Location

Street Address 4950 CHILDRENS PL
City SAINT LOUIS
State MO
Zip Code 63110-1000

Providers in the same location

NPI Name Taxonomy Address Enumeration
1841221116 Washington University Clinic/Center 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-07-05
1487015061 Holly A Dockins Dietitian, Registered 4950 Childrens Pl, Saint Louis, MO 63110-1000 2016-03-10
1851509624 Barnes-jewish Hospital General Acute Care Hospital 4950 Childrens Pl, Barnes-jewish Hospital, Saint Louis, MO 63110-1000 2007-05-17
1093844540 Mary V Mason General Practice 4950 Childrens Pl, Wohl Medicine Clinic 5th Fl, Saint Louis, MO 63110-1000 2007-03-02
1437256468 Melvin S Blanchard Internal Medicine 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-09-20
1578574844 Ernie-paul Barrette Internal Medicine 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-08-11
1467470195 Brian F Gage Internal Medicine 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-07-18
1073531521 William Edward Clutter Internal Medicine 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-07-17
1073531497 Carlos Bernal Internal Medicine 4950 Childrens Pl, Saint Louis, MO 63110-1000 2006-07-17
1578580007 Katherine E Henderson General Practice 4950 Childrens Pl, Wohl Clinic 5th Fl, Saint Louis, MO 63110-1000 2006-07-17
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1659971992 Carrie Ellen Smith Nurse Practitioner Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 2020-10-27
1881210466 Michelle Amanda Freilich Internal Medicine Barnes-jewish Plaza, St. Louis, MO 63110 2020-06-19
1245856046 Jeevin Shahi Radiology 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 2020-06-18
1497371314 Wilson Eduardo Rodriguez Student in an Organized Health Care Education/Training Program 1008 S. Spring, St Louis, MO 63110 2020-06-17
1578184065 Kathryn Kay Lindsay Registered Nurse Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 2020-05-06
1881232700 Ashley Diane Pace Nurse Practitioner 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 2019-12-11
1619520418 Krithika Damodar Shenoy Pathology 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 2019-07-20
1467912550 Ian Ferguson Dermatology 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 2019-03-23
1760978688 Ihab Hassanieh Student in an Organized Health Care Education/Training Program 33660 Vista Ave, St. Louis, MO 63110 2018-07-03
1336634500 Martin K Mwangi Pediatrics 1 Childrens Place, 3s34, St. Louis, M, MO 63110 2018-06-28
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Taxonomy Information

Taxonomy Code 363LA2200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Adult Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1023619285 Jennifer Lee Speiser Nurse Practitioner 12545 Olive Blvd, Saint Louis, MO 63141-6311 2020-11-04
1265045264 Andrea Jane Montgomery Nurse Practitioner 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 2020-08-28
1396362224 Erin M Kehoe Nurse Practitioner 12973 Olive Blvd, Saint Louis, MO 63141-6149 2020-06-26
1508482506 Matthew Dale Tieskoetter Nurse Practitioner 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 2020-06-25
1861033615 Benedicta Esi Nurse Practitioner 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 2019-10-02
1245896893 Katina D Smith Nurse Practitioner 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 2019-05-18
1912413584 Lucija Kozul Sadl Nurse Practitioner 3525 Forest Dale Dr, Saint Louis, MO 63125-4212 2017-12-19
1275071326 Kathryn Ries Nurse Practitioner 3535 South Broadway, Suite 118, Saint Louis, MO 63118-3907 2017-02-09
1144775966 Hienok Hailu Nurse Practitioner 11725 Casa Grande Dr, Saint Louis, MO 63146-4223 2016-08-22
1992167522 Lanyn Clark Nurse Practitioner 40 Ladue Ter, Saint Louis, MO 63124-2048 2016-03-23
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Competitor

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City SAINT LOUIS
Zip Code 63110

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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