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Organization

CARDINAL GLENNON CHILDREN'S HOSPITAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MISS SHANNON LANEE MILLER RN, MSN, CPNP (PEDIATRIC NURSE PRACTITIONER)
(618) 975-1607
Entity
Organization

Contact information

Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5666
Mailing address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5666

Taxonomy

Speciality
Code
Description
License number
State
282NC2000X
Children's Hospital
Primary
MO151383
MO

Other

Enumeration date
11/13/2009
Last updated
11/13/2009
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