Individual
MARY ELLEN YEMM-SHORES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2345 DOUGHERTY FERRY RD, SAINT LOUIS, MO 63122-3313
(314) 821-5850
Mailing address
13523 BARRETT PARKWAY DR, SUITE 210, BALLWIN, MO 63021-3802
(314) 775-2816
(314) 775-2821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
070055
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430053121
RR MEDICARE
MO
05
—
913632956
—
MO
Enumeration date
11/09/2005
Last updated
06/25/2010
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