Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

SSM St Charles Clinic Medical Group

Organization Family Nurse Practitioner · NPI 1518396670

SSM St Charles Clinic Medical Group is a Family Nurse Practitioner in Lake St Louis, Missouri. Licensed in Missouri. Registered with an NPI since 2013.

Licensed in
MO
In the registry since
2013

Practice location Address checks out

400 Medical Plz Ste 200
Lake St Louis, MO 63367-1490
Phone: (636) 625-2662
Fax: (636) 625-1121
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2013015582 (MO)

Record details

NPI number1518396670
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Laura Pullum — Director · (636) 669-2434
NPI enumeratedNovember 8, 2013
Last updated in NPPESNovember 8, 2013
Mailing address1551 Wall St, Suite 310, Saint Charles, MO 63303-3539

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