Healthcare Provider Details

I. General information

NPI: 1841214335
Provider Name (Legal Business Name): MARGARET J BROTHERS RN, CS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PEGGY J. BROTHERS RN, CS

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1085 MAPLE ST
FARMINGTON MO
63640-1955
US

IV. Provider business mailing address

1430 OLIVE ST SUITE 400
SAINT LOUIS MO
63103-2303
US

V. Phone/Fax

Practice location:
  • Phone: 573-756-5353
  • Fax: 573-756-4557
Mailing address:
  • Phone: 573-756-5353
  • Fax: 573-756-4557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License Number115567
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: