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Individual

CECELIA PRATT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
621 S NEW BALLAS RD STE 560A, SAINT LOUIS, MO 63141-8261
(314) 251-6440
Mailing address
606 PRAIRIEGATE CT, LAKE SAINT LOUIS, MO 63367-4362
(636) 541-4607

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2012024057
MO
363LF0000X
Family Nurse Practitioner
Primary
F03170063
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1144714023
MO
01
2012024057
MISSOURI STATE BOARD OF NURSING
MO
01
F03170063
AMERICAN ACADEMY OF NURSE PRACTITIONERS CERTIFICATION BOARD
MO
Enumeration date
06/14/2018
Last updated
01/30/2024
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