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Matthew Dale Tieskoetter, APRN
Adult Health Nurse Practitioner in Bridgeton, Missouri
NPI 1508482506

Matthew Dale Tieskoetter is an Adult Health Nurse Practitioner based in Saint Louis, MO and is specialized in Adult Health. Matthew Dale Tieskoetter practices in Bridgeton, MO and has the professional credentials of APRN. The NPI Number for Matthew Dale Tieskoetter is 1508482506 and holds a License No. 2020003584 (Missouri).

The current practice location address for Matthew Dale Tieskoetter is 12349 De Paul Dr Ste 100, Bridgeton, MO and can be reached out via phone at 314-291-7900.

Location: 12349 De Paul Dr Ste 100, Bridgeton, MO, 63195-5534
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1508482506
Provider Name
Matthew Dale Tieskoetter
Credential
APRN
Provider Entity Type
Individual
Gender
Male
Address
12349 De Paul Dr Ste 100, Bridgeton, MO, 63195-5534
Phone Number
314-291-7900
Fax Number
Provider Enumeration Date
06/25/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
12349 De Paul Dr Ste 100
City
Bridgeton
State
Missouri
Zip
63044-2512
Phone Number
314-291-7900
Fax Number
person
Provider Business Mailing Address Details
Address
12349 De Paul Dr Ste 100
City
Bridgeton
State
Missouri
Zip
63044-2512
Phone Number
314-291-7900
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
363LA2200X
License No.
2020003584 (Missouri)
Definition
Definition to come...
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