STACIE D DETMER

FENTON, MO
NPI1235380064
Former NameSTACIE D LANE
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LF0000X Nurse Practitioner, Family
(Licence: MO  2005018747)
Enumeration Date2008-10-10
Last Update Date2019-05-21
Business Address
STACIE D DETMER FNP
1011 BOWLES AVE STE 450
FENTON, MO 63026-0562
Phone number: 314-467-1500
Mailing Address
STACIE D DETMER FNP
PO BOX 23340
SAINT LOUIS, MO 63156-3340
Phone number: 314-851-1000
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