Individual
MRS. MARY ELLEN MYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, APRN-C
Contact information
Practice address
3535 S JEFFERSON AVE, SAINT LOUIS, MO 63118-3930
(314) 776-7999
(844) 848-6137
Mailing address
1694 VALERO LN, FENTON, MO 63026-3259
(314) 540-0623
(844) 848-6137
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
RN077928
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2500032240
BNDD-MISSOURI
MO
Enumeration date
03/17/2006
Last updated
03/07/2023
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