Individual provider · Type 1 NPI
Michael Stephen Logue, FAM NRS PRAC FNP
Family Nurse Practitioner · St. Louis, MO
NPI number
1750338919
Active
Practice location
10012 Kennerly Road, Suite # 301
St. Louis, MO 63128
Fax (314) 729-1489
Mailing address
11140 S Towne Square, Suite # 105
St. Louis, MO 63123
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 135879 (MO) |
| Family Nurse Practitioner | 363LF0000X | 209004468 (IL) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1750338919
Michael Stephen Logue, FAM NRS PRAC FNP's National Provider Identifier is 1750338919, issued on May 30, 2006. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in St. Louis, MO. The record was last updated on Nov 7, 2007.