Provider Demographics
NPI:1912413584
Name:SADL, LUCIJA KOZUL (AGPCNP-BC AND NP-C)
Entity type:Individual
Prefix:
First Name:LUCIJA
Middle Name:KOZUL
Last Name:SADL
Suffix:
Gender:
Credentials:AGPCNP-BC AND NP-C
Other - Prefix:
Other - First Name:LUCY
Other - Middle Name:KOZUL
Other - Last Name:SADL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AGPC-BC AND NP-C
Mailing Address - Street 1:PO BOX 14369
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63178-4369
Mailing Address - Country:US
Mailing Address - Phone:314-729-0077
Mailing Address - Fax:
Practice Address - Street 1:1010 OLD DES PERES RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1865
Practice Address - Country:US
Practice Address - Phone:314-729-0077
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOAG11170104363LA2200X
MO2017018302363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health