Individual
NANCY BIRTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
6209 MID RIVERS MALL DR, SUITE 317, SAINT PETERS, MO 63304-1102
(636) 244-4500
(636) 244-4505
Mailing address
6209 MID RIVERS MALL DR, SUITE 317, SAINT PETERS, MO 63304-1102
(636) 244-4500
(636) 244-4505
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2015034704
MO
364SP0809X
Adult Psychiatric/Mental Health Clinical Nurse Specialist
107603
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424724110
—
MO
01
—
P00171562
RAILROAD MEDICARE
MO
Enumeration date
07/19/2005
Last updated
02/10/2023
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