Individual
MRS. BRANDIE MARIE SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC, PHD
Contact information
Practice address
309 N QUAIL POINT DR, O FALLON, MO 63366-5244
(314) 791-7346
Mailing address
309 N QUAIL POINT DR, O FALLON, MO 63366-5244
(314) 791-7346
(314) 843-4856
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041339458
IL
163W00000X
Registered Nurse
2007005639
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
2007005639
MO
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
309.017069
IL
Other
Enumeration date
08/10/2011
Last updated
06/29/2023
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