Provider Demographics
NPI:1063105781
Name:LEDET, HALI DANAE (CNM)
Entity type:Individual
Prefix:
First Name:HALI
Middle Name:DANAE
Last Name:LEDET
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2355 S 10TH ST APT 1
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63104-4231
Mailing Address - Country:US
Mailing Address - Phone:337-501-2960
Mailing Address - Fax:
Practice Address - Street 1:3396 PERSHALL RD
Practice Address - Street 2:
Practice Address - City:FERGUSON
Practice Address - State:MO
Practice Address - Zip Code:63135
Practice Address - Country:US
Practice Address - Phone:337-501-2960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-30
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023035147363LF0000X
MO2023035148367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily