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:
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Health care specialties

SpecialtyCodeLicense #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 7 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 1114486743 NPPES
Missouri MEDICAID 431921811

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