Bradley, Lisa Charisee
Bradley, Lisa Charisee is an individual health care provider with primary practice located at 4135 Holman Ln , Saint Louis MO 63134-3925. She recently has only one registered license in Nursing Service Related Providers / Homemaker, which is considered as her primary health care specialty. Bradley, Lisa Charisee can be contacted via phone (314) 479-6121.Contact Information
Primary practice address
4135 Holman Ln
Saint Louis MO 63134-3925
Phone: (314) 479-6121
Fax: (314) 479-6121
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Related Providers / Homemaker | 376J00000X | Missouri |
Profile Details
NPI number | 1114486743 |
---|---|
LBN Legal business name | Bradley, Lisa Charisee |
Credentials | REGISTERED NURSE |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 13th, 2019 |
Last updated | Mar 13th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1114486743 | NPPES |
Missouri | MEDICAID | 431921811 |
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