Provider Demographics
NPI:1124425400
Name:STENSLAND, ANNE NICOLE (AGNP)
Entity type:Individual
Prefix:MS
First Name:ANNE
Middle Name:NICOLE
Last Name:STENSLAND
Suffix:
Gender:
Credentials:AGNP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 7412035
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-2035
Mailing Address - Country:US
Mailing Address - Phone:314-367-3113
Mailing Address - Fax:314-367-6491
Practice Address - Street 1:1110 HIGHLANDS PLAZA DR E
Practice Address - Street 2:STE 375
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110-1392
Practice Address - Country:US
Practice Address - Phone:314-367-3113
Practice Address - Fax:314-367-6491
Is Sole Proprietor?:No
Enumeration Date:2014-12-02
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2014042046363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420018738Medicaid