Stephanie Lickerman, APRN, ANP-BC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

2011006713 Issued in MO

Practice address

121 Saint Lukes Center Dr
Ste 303
Chesterfield, MO 63017-3509

Phone

(314) 434-3278

Fax

(314) 590-5949

NPI assigned

Apr 22, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mercy Clinic Cardiovascular and Thoracic Surgery, LLC

  • Vascular Surgery Physician
  • Washington, MO
  • NPI 1528192416
  NPD (past)
• Mercy Clinic Heart and Vascular, LLC

  • Cardiovascular Disease Physician
  • Saint Louis, MO
  • NPI 1932176401
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1023309200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SAINT LUKES CENTER DR",
            "address_2": "STE 303",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "314-434-3278",
            "fax_number": "314-590-5949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SAINT LUKES CENTER DR",
            "address_2": "STE 303",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173509",
            "telephone_number": "314-434-3278",
            "fax_number": "314-590-5949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICKERMAN",
        "first_name": "STEPHANIE",
        "credential": "APRN, ANP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-04-22",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MO",
            "license": "2011006713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Violet Li
• Stanley L Librach, M.D.
• Faye Licata, DMD FAGD PC
• Rayvlin John Talavera Liceralde, MD
• David S Lickerman, MD
• Micah J Lieberman, D.C.
• Brandi Liebig, MS,CCC-SLP
• Life Care Home Health Services LLC
• Lifetime Dental Care of Missouri, Richard Straus, D.M.D., P.C.
• Martin Light

• Adult Health Nurse Practitioner in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Adult Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.