Individual
BRANT HARBER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
639 CASTLE RIDGE DR, BALLWIN, MO 63021-4464
(314) 210-9095
Mailing address
639 CASTLE RIDGE DR, BALLWIN, MO 63021-4464
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2017040113
MO
363LA2200X
Adult Health Nurse Practitioner
2017040113
MO
363LG0600X
Gerontology Nurse Practitioner
2017040113
MO
Other
Enumeration date
04/20/2021
Last updated
04/20/2021
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