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Individual

MRS. ANNE MARIE BANNISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AGNP

Contact information

Practice address
4460 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1647
(314) 843-7557
Mailing address
4460 S LINDBERGH BLVD, SAINT LOUIS, MO 63127-1647
(314) 843-7557

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2015001253
MO
363LG0600X
Gerontology Nurse Practitioner
2015001253
MO
363LP2300X
Primary Care Nurse Practitioner
2015001253
MO

Other

Enumeration date
02/16/2015
Last updated
06/12/2024
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