Healthcare Provider Details

I. General information

NPI: 1285735662
Provider Name (Legal Business Name): NANCY B. QUIGLEY CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 05/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11630 STUDT AVE SUITE 200
CREVE COEUR MO
63141-7016
US

IV. Provider business mailing address

PO BOX 23340
SAINT LOUIS MO
63156-3340
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-7337
  • Fax: 314-851-4476
Mailing address:
  • Phone: 314-567-7337
  • Fax: 314-851-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number053168
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: