Individual
MS. CARLISS RENE GARRETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4488 FOREST PARK AVE, DIV NEUROLOGY ADULT, STE 160, SAINT LOUIS, MO 63108-2283
(314) 362-1408
(314) 747-8427
Mailing address
PO BOX 7412011, CHICAGO, IL 60674-2011
(314) 362-1408
(314) 747-8427
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2016015403
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
429636103
—
MO
Enumeration date
05/09/2012
Last updated
04/17/2025
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