Kormos, Theresa C

Kormos, Theresa C is an individual health care provider with primary practice located at 1201 Bellevue Ave , Saint Louis MO 63117-1701. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult, which is considered as her primary health care specialty. Kormos, Theresa C can be contacted via phone (314) 647-4488.

Contact Information

Primary practice address
1201 Bellevue Ave Saint Louis MO 63117-1701
Phone: (314) 647-4488
Fax: (314) 647-6305
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Adult 364SP0809X 146030 Missouri

Profile Details

NPI number 1194863431
LBN Legal business name Kormos, Theresa C
Credentials MSN, RN
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 1st, 2007
Last updated Jun 2nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194863431 NPPES
Missouri MEDICAID 423961911

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