Healthcare Provider Details

I. General information

NPI: 1114782406
Provider Name (Legal Business Name): NICHOLE MEIER APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/16/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10000 WATSON RD STE 2-L28
SAINT LOUIS MO
63126-1848
US

IV. Provider business mailing address

7818 PINETOP DR
SAINT LOUIS MO
63129-2391
US

V. Phone/Fax

Practice location:
  • Phone: 314-223-2694
  • Fax:
Mailing address:
  • Phone: 314-223-2694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2024006161
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2024006161
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: