Provider Demographics
NPI:1326876236
Name:VAIZERS, EWA (FNP-C)
Entity type:Individual
Prefix:
First Name:EWA
Middle Name:
Last Name:VAIZERS
Suffix:
Gender:F
Credentials:FNP-C
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 STE 2335
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6165
Mailing Address - Country:US
Mailing Address - Phone:314-653-5007
Mailing Address - Fax:314-455-8001
Practice Address - Street 1:6 JUNGERMANN CIR STE 210
Practice Address - Street 2:
Practice Address - City:SAINT PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1625
Practice Address - Country:US
Practice Address - Phone:636-441-6056
Practice Address - Fax:636-441-0620
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-23
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2024029374363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty