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Louise Blase

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

3009 N Ballas Rd Ste 227a, Saint Louis, MO 63131-2308

PECOS Enrollment

Based on the most recent information from CMS, provider Louise Blase is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1154789048
Provider Type
Individual
Full Name
Blase, Louise
Credential
NP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
2/5/2016
Last Updated
8/16/2024

Contact Information

Practice Location

3009 N Ballas Rd Ste 227a, Saint Louis, MO 63131-2308

(314) 448-3791

Unlisted Fax

Mailing Location

PO Box 959354, Saint Louis, MO 63195-2329

(314) 996-5000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2015040102 Missouri
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 2015040102 Missouri

Louise Blase

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Hudson, Latania

Bayne, Ann Marie

Fegan, Jessica Leigh

Barone, Natalie Michelle

Davis, Amy L

Lemp, Shannon E

Sanderson, Lauren Christine

Emery, Valerie Beckham

Hopper, Stacy

Tench, Cynthia C