Provider Demographics
NPI:1710721055
Name:MOHSEN, AYAT ADEL (CNM)
Entity type:Individual
Prefix:
First Name:AYAT
Middle Name:ADEL
Last Name:MOHSEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 959354
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63195-9354
Mailing Address - Country:US
Mailing Address - Phone:314-644-3336
Mailing Address - Fax:314-644-5606
Practice Address - Street 1:8888 LADUE ROAD
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-2326
Practice Address - Country:US
Practice Address - Phone:314-996-3531
Practice Address - Fax:314-644-5606
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
367A00000X
MO2024031668367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife