Individual
MRS. JOAN M MCCOURT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
233 CLARKSON RD, ELLISVILLE, MO 63011-2219
(636) 256-8644
Mailing address
233 CLARKSON RD, ELLISVILLE, MO 63011-2219
(636) 256-8644
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
069564
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
069564
LICENSE
MO
Enumeration date
05/20/2013
Last updated
07/17/2013
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