Individual
MARY ELLEN COLYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
10 HOSPITAL DR, ST PETERS, MO 63376-1659
(314) 895-3828
(636) 922-5157
Mailing address
PO BOX 5, HAZELWOOD, MO 63042-0005
(314) 895-3828
(636) 922-5157
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
047943
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430063799
RAILROAD MEDICARE
MO
05
—
919444109
—
MO
Enumeration date
10/10/2005
Last updated
03/12/2013
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