Healthcare Provider Details

I. General information

NPI: 1437009222
Provider Name (Legal Business Name): HANNAH IRENE BRASIER PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

224 BRADFORD LN
WATERLOO IL
62298-3369
US

IV. Provider business mailing address

170 MARTIGNEY DR
SAINT LOUIS MO
63129-3410
US

V. Phone/Fax

Practice location:
  • Phone: 618-939-0112
  • Fax:
Mailing address:
  • Phone: 618-939-0112
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2025006769
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: