Individual
NICOLE DENISE CARR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, BSN, MSN, FNP-BC
Contact information
Practice address
3545 LAFAYETTE AVE, SAINT LOUIS, MO 63104-1314
(314) 977-9050
Mailing address
6915 ROLAND BLVD, SAINT LOUIS, MO 63121-2723
(314) 614-4760
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2019035274
MO
Other
Enumeration date
04/23/2020
Last updated
04/23/2020
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