Healthcare Provider Details

I. General information

NPI: 1447194782
Provider Name (Legal Business Name): MARISSA ELIZABETH SHEARER MSN, APRN, ACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 S GRAND BLVD
SAINT LOUIS MO
63104-1016
US

IV. Provider business mailing address

10711 SAINT MATTHEW LN
SAINT ANN MO
63074-2616
US

V. Phone/Fax

Practice location:
  • Phone: 314-607-8156
  • Fax:
Mailing address:
  • Phone: 314-607-8156
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2026007462
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number2026007462
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: