Individual
MRS. BERTHA Y CARTER-SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
111 S MERAMEC AVE, CLAYTON, MO 63105-1711
(314) 615-8153
(314) 615-8303
Mailing address
111 S MERAMEC AVE, CLAYTON, MO 63105-1711
(314) 615-8153
(314) 615-8303
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
052258
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
423989417
—
MO
01
—
P00213367
MEDICARE RAILROAD
MO
Enumeration date
08/21/2006
Last updated
07/08/2007
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