Wogene Amsalu, | |
9628 Midland Blvd, Overland, MO 63114-3357 | |
(314) 779-6022 | |
Not Available |
Full Name | Wogene Amsalu |
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Gender | Female |
Speciality | Nurse Practitioner - Primary Care |
Location | 9628 Midland Blvd, Overland, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1184091431 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163W00000X | Registered Nurse | 2002031108 (Missouri) | Secondary |
363LP2300X | Nurse Practitioner - Primary Care | 2018001284 (Missouri) | Primary |
Entity Name | Washington University |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1760422265 PECOS PAC ID: 9830008770 Enrollment ID: O20040812001332 |
Entity Name | Liaison Health Group Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033874888 PECOS PAC ID: 6901298298 Enrollment ID: O20220118002422 |
Mailing Address | Practice Location Address |
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Wogene Amsalu, 1131 Indian Trails Dr, Saint Louis, MO 63132-3109 Ph: () - | Wogene Amsalu, 9628 Midland Blvd, Overland, MO 63114-3357 Ph: (314) 779-6022 |
Ms. Rachel Nicole Ramos, AGNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9150 Overland Plz, Overland, MO 63114 Phone: 314-449-9633 Fax: 314-949-3428 | |
Kristen E Evans, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 9150 Overland Plz, Overland, MO 63114 Phone: 314-449-9633 |