Individual provider · Type 1 NPI

Jeffrey Michael Ditter, NP

Nurse Practitioner · Lake St. Louis, MO

NPI number 1508307190 Active

Practice location

100 Medical Plz
Lake St. Louis, MO 63367-1366

Call (636) 625-5200 Map

Fax (636) 625-5314

Mailing address

200 Corporate Blvd
Lafayette, LA 70508-3870

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner 363L00000XA155084 (IA)
Nurse Practitioner Primary 363L00000X2017004715 (MO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1508307190

Jeffrey Michael Ditter, NP's National Provider Identifier is 1508307190, issued on Mar 15, 2017. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Lake St. Louis, MO. The record was last updated on Jan 13, 2021.