Amy Kathleen Licis in Saint Louis - Neurology
Amy Kathleen Licis - NPI 1992914352
Amy Kathleen Licis is a Neurology in Saint Louis, Missouri. Amy Kathleen Licis practices all healthcare services and medical treatments related to Neurology. The NPI Number for Amy Kathleen Licis is 1992914352. The last update date is 2021-11-15.
Amy Kathleen Licis's current location address is 1600 S Brentwood Blvd, Saint Louis, Missouri. You can contact this provider via phone number 3143621408 and fax number 3144542523. The mailing address for Amy Kathleen Licis is 1600 S Brentwood Blvd, Saint Louis, Missouri. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Amy Kathleen Licis |
|---|---|
| Address | 1600 S Brentwood Blvd, Saint Louis, Missouri |
| Phone Number | 3143621408 |
| Fax Number | 3144542523 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1992914352 |
|---|---|
| Provider Enumeration Date | 2007-05-22 |
| Last Updated Date | 2021-11-15 |
Provider Mailing Address Detail
| Address | 1600 S Brentwood Blvd |
|---|---|
| City | Saint Louis |
| State | Missouri (MO) |
| Post Code | 631441320 |
| Phone Number | 3143621408 |
| Fax Number | 3144542523 |
Provider's Primary Taxonomy Detail
| Speciality | Neurology |
|---|---|
| Taxonomy | 2084N0400X |
| Licence No | 2009014878 |
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Definition: A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 204515803 | MO | -- |
Post Comment/ Review Below
What is the unique 10-digit identifier code assigned to Amy Kathleen Licis by the Centers for Medicare & Medicaid Services?
The Amy Kathleen Licis has been issued the NPI (National Provider Identifier) 1992914352 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you please provide the complete street address where Amy Kathleen Licis is physically located?
The Amy Kathleen Licis is physically situated at the following address: 1600 S Brentwood Blvd, Saint Louis, MO, 631441320.
What is the area of specialization for Amy Kathleen Licis, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Amy Kathleen Licis is Neurology, and the corresponding taxonomy code that categorizes this area of expertise is 2084N0400X.
On what date did the Amy Kathleen Licis receive the assignment of its 1992914352 from the Centers for Medicare & Medicaid Services?
The Amy Kathleen Licis was issued its 1992914352 by the Centers for Medicare & Medicaid Services on 2007-05-22.
As of what date were the details pertaining to Amy Kathleen Licis last refreshed?
The information related to the Amy Kathleen Licis, including its address, specialty, and other relevant details, was last updated on 2021-11-15.