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1558576561
LISA M ROTH
SAINT LOUIS, MO
NPI
1558576561
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LN0005X Nurse Practitioner, Neonatal, Critical Care
(Licence: MO 066591)
Enumeration Date
2007-05-12
Last Update Date
2007-07-08
Business Address
-- LISA M ROTH RNC NNP
1465 S GRAND BLVD
SAINT LOUIS, MO 63104-1003
Phone number: 314-577-5631
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Mailing Address
-- LISA M ROTH RNC NNP
3815 HOLLY HILLS BLVD
SAINT LOUIS, MO 63116-3134
Phone number: 314-752-4327
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