Individual provider · NPI-1

Andrea Desi Rae Bieser, RN

Registered Nurse, General Practice · Saint Louis, MO

NPI number1417445370
StatusActive
Last updated in NPPESApr 26, 2018

Details

NPI
1417445370
Entity type
Individual (NPI-1)
Name
Andrea Desi Rae Bieser
Credential
RN
Sex
Female
Sole proprietor
Yes
Enumeration date
Apr 26, 2018
Last updated
Apr 26, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice2015012879MOYes

Practice location

1430 Olive St
Saint Louis, MO 63103-2360

Phone 314-645-6840 · Fax 314-621-5006

Mailing address

3258 5 Oaks Dr
Arnold, MO 63010-3883

Phone 573-747-9039

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