# CARDINAL GLENNON CHILDREN'S HOSPITAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699002527
- **Authorized official:** MISS SHANNON LANEE MILLER RN, MSN, CPNP (PEDIATRIC NURSE PRACTITIONER)
- **Authorized official phone:** (618) 975-1607

## Contact information

- **Practice address:** 1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
- **Practice address phone:** (314) 577-5666
- **Mailing address:** 1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
- **Mailing address phone:** (314) 577-5666

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282NC2000X | Children's Hospital | MO151383 | MO | Yes |

## Other

- **Enumeration date:** 11/13/2009
- **Last updated:** 11/13/2009