Healthcare Provider Details

I. General information

NPI: 1457877979
Provider Name (Legal Business Name): MEREDITH NORMAN APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MEREDITH SCHOENE

II. Dates (important events)

Enumeration Date: 08/16/2017
Last Update Date: 07/26/2021
Certification Date: 07/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12255 DE PAUL DR STE 500
BRIDGETON MO
63044-2515
US

IV. Provider business mailing address

PO BOX 955534
SAINT LOUIS MO
63195-5534
US

V. Phone/Fax

Practice location:
  • Phone: 314-209-5180
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2017029541
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: