Brueggemann, Mary Beth
Brueggemann, Mary Beth is an sole proprietor health care provider with primary practice located at 915 N Grand Blvd , Saint Louis MO 63106-1621. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Adult Health, which is considered as her primary health care specialty. Brueggemann, Mary Beth can be contacted via phone (314) 652-4100.Contact Information
Primary practice address
915 N Grand Blvd
Saint Louis MO 63106-1621
Phone: (314) 652-4100
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Adult Health | 363LA2200X | 079422 | Missouri |
Profile Details
| NPI number | 1518133446 |
|---|---|
| LBN Legal business name | Brueggemann, Mary Beth |
| Credentials | APRN-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 30th, 2008 |
| Last updated | Apr 30th, 2008 - about 16 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 | 1518133446 | NPPES |
| Missouri | MEDICAID | 429300205 |
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