Individual
EDMOND JAMES MEYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BSN, RN, AE-C
Contact information
Practice address
2638 HIGHWAY 109 STE 100, WILDWOOD, MO 63040-1161
(636) 452-7689
(636) 452-7689
Mailing address
2638 HIGHWAY 109 STE 100, WILDWOOD, MO 63040-1161
(636) 452-7689
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
151689
MO
174H00000X
Health Educator
6086
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
151689
MISSOURI STATE BOARD OF NURSING
MO
Enumeration date
09/19/2017
Last updated
07/21/2022
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