Individual
CARLA MOORE BECKERLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
637 DUNN RD STE 170, HAZELWOOD, MO 63042-1759
(314) 838-5702
(314) 839-5596
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(314) 851-1000
(314) 851-4477
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
072603
MO
363L00000X
Nurse Practitioner
209017488
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427553102
—
MO
Enumeration date
09/20/2006
Last updated
03/15/2019
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