Provider Demographics
NPI:1639316946
Name:STEGEMEIER, MARCEE LEIGH (APRN-BC)
Entity type:Individual
Prefix:
First Name:MARCEE
Middle Name:LEIGH
Last Name:STEGEMEIER
Suffix:
Gender:F
Credentials:APRN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11133 DUNN RD
Mailing Address - Street 2:SUITE 2335
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6119
Mailing Address - Country:US
Mailing Address - Phone:314-653-5007
Mailing Address - Fax:314-653-4149
Practice Address - Street 1:11133 DUNN RD STE 2335
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6165
Practice Address - Country:US
Practice Address - Phone:314-653-5007
Practice Address - Fax:314-653-4149
Is Sole Proprietor?:No
Enumeration Date:2009-01-08
Last Update Date:2019-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO120269363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO424389302Medicaid
MO1639316946Medicaid
MO1164534210Medicaid
MO000010417Medicare PIN
MO104170004Medicare PIN