Individual
MR. NICHOLAS DAVID LONGFELLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ACNP
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, DEPT ANESTHESIOLOGY, SAINT LOUIS, MO 63110-1003
(800) 862-9980
(314) 362-1185
Mailing address
660 S EUCLID AVE, CB 8054, SAINT LOUIS, MO 63110-1010
(800) 862-9980
(314) 362-1185
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
2020029661
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420089047
—
MO
Enumeration date
08/07/2020
Last updated
11/15/2021
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