Individual
CAITLIN PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
915 N GRAND BLVD, SAINT LOUIS, MO 63106-1621
(314) 652-4100
Mailing address
93 OAK RIDGE ESTATES DR, GLEN CARBON, IL 62034-1532
(618) 406-7738
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209009460
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209009460
LICENSE
IL
Enumeration date
04/05/2012
Last updated
02/19/2025
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