Provider Demographics
NPI:1841386737
Name:SERR, SYNDEE J (ANP)
Entity Type:Individual
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First Name:SYNDEE
Middle Name:J
Last Name:SERR
Suffix:
Gender:F
Credentials:ANP
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Other - Last Name:
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Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:314-996-7644
Mailing Address - Fax:314-996-7658
Practice Address - Street 1:200 SOUTHAMPTON DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3032
Practice Address - Country:US
Practice Address - Phone:573-499-9009
Practice Address - Fax:573-499-4400
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-07-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO070372363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424575405Medicaid
MO000081433Medicare PIN
MO424575405Medicaid