Provider Demographics
NPI:1316362833
Name:MEHLER, ANGELA
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:MEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 WALLS FORD RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIR
Mailing Address - State:MO
Mailing Address - Zip Code:63077-2227
Mailing Address - Country:US
Mailing Address - Phone:636-234-4775
Mailing Address - Fax:
Practice Address - Street 1:10649 STATE HIGHWAY A
Practice Address - Street 2:
Practice Address - City:RICHWOODS
Practice Address - State:MO
Practice Address - Zip Code:63071-2558
Practice Address - Country:US
Practice Address - Phone:573-678-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2014-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014005147363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily