Individual
NANCY T. VANCLEAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5600
Mailing address
1836 LACKLAND HILL PKWY, ATTNT CREDENTIALING DEPT, SAINT LOUIS, MO 63146-3572
(314) 989-0300
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
054044
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
427447206
—
MO
Enumeration date
02/28/2007
Last updated
11/04/2009
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