Provider Demographics
NPI:1811255342
Name:SILVERMAN, LISA G (PNP)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:G
Last Name:SILVERMAN
Suffix:
Gender:
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412011
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2011
Mailing Address - Country:US
Mailing Address - Phone:314-454-2076
Mailing Address - Fax:314-747-8953
Practice Address - Street 1:3015 N BALLAS RD
Practice Address - Street 2:DIV PED HOSPITALIST MEDICINE
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2329
Practice Address - Country:US
Practice Address - Phone:314-454-2076
Practice Address - Fax:314-747-8953
Is Sole Proprietor?:No
Enumeration Date:2012-05-03
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016020290363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420060341Medicaid