Provider Demographics
NPI:1558348045
Name:BITZER, MARIA ANN (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:ANN
Last Name:BITZER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 CEDAR PLAZA PKWY
Mailing Address - Street 2:SUITE 350
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-3854
Mailing Address - Country:US
Mailing Address - Phone:314-843-4333
Mailing Address - Fax:314-842-0772
Practice Address - Street 1:205 ELM ST
Practice Address - Street 2:SUITE 202
Practice Address - City:WASHINGTON
Practice Address - State:MO
Practice Address - Zip Code:63090-2342
Practice Address - Country:US
Practice Address - Phone:636-390-4071
Practice Address - Fax:636-390-8908
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014013262363LP0808X
MO97105363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425271715Medicaid
MO425271707Medicaid
P29509Medicare UPIN