Provider Demographics
NPI:1487012845
Name:SSM HEALTH
Entity Type:Organization
Organization Name:SSM HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP-C
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:
Authorized Official - Last Name:VISINTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-402-5308
Mailing Address - Street 1:1524 CLEO CT
Mailing Address - Street 2:
Mailing Address - City:HIGH RIDGE
Mailing Address - State:MO
Mailing Address - Zip Code:63049-1414
Mailing Address - Country:US
Mailing Address - Phone:314-402-5308
Mailing Address - Fax:
Practice Address - Street 1:1296 JEFFCO BLVD
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MO
Practice Address - Zip Code:63010-2138
Practice Address - Country:US
Practice Address - Phone:636-321-8600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-01
Last Update Date:2016-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital