Basic Information
Provider Information
NPI: 1295909414
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EGGEMEYER
FirstName: LINDA
MiddleName: M
NamePrefix: MS.
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: SCHERRER
OtherFirstName: LINDA
OtherMiddleName: M
OtherNamePrefix: MRS.
OtherNameSuffix:  
OtherCredential: RN
OtherLastNameType: 1
Mailing Information
Address1: 1100 S GRAND
Address2:  
City: ST. LOUIS
State: MO
PostalCode: 631041015
CountryCode: US
TelephoneNumber: 3149776351
FaxNumber: 3149776340
Practice Location
Address1: 1100 S GRAND
Address2:  
City: ST. LOUIS
State: MO
PostalCode: 631041015
CountryCode: US
TelephoneNumber: 3149776351
FaxNumber: 3149776340
Other Information
ProviderEnumerationDate: 04/18/2008
LastUpdateDate: 04/18/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X110899MOY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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