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Individual

CARL KEITH CALLAHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
13131 TESSON FERRY RD STE 220, SAINT LOUIS, MO 63128-3887
(314) 394-1379
(314) 394-1377
Mailing address
13131 TESSON FERRY RD, STE 220, SAINT LOUIS, MO 63128-3887
(314) 394-1379
(314) 394-1377

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015039591
MO

Other

Enumeration date
11/30/2015
Last updated
03/17/2018
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