Individual
MS. MARY ELIZABETH CRECELIUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHNP
Contact information
Practice address
255 BODERMAN, BLOOMSDALE, MO 63627-9099
(573) 483-2727
(573) 883-2463
Mailing address
PO BOX 366, STE GENEVIEVE, MO 63670-0366
(573) 883-4473
(573) 883-4472
Taxonomy
Speciality
Code
Description
License number
State
170300000X
Genetic Counselor (M.S.)
—
—
363LW0102X
Women's Health Nurse Practitioner
Primary
089458
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
428718712
—
MO
Enumeration date
11/16/2005
Last updated
06/03/2022
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