Healthcare Provider Details

I. General information

NPI: 1386793388
Provider Name (Legal Business Name): JANENE RAE VERRANT PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

269 LE BEAU LN
SAINT CHARLES MO
63303-4212
US

IV. Provider business mailing address

269 LE BEAU LN
SAINT CHARLES MO
63303-4212
US

V. Phone/Fax

Practice location:
  • Phone: 314-223-3253
  • Fax:
Mailing address:
  • Phone: 314-223-3253
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835G0303X
TaxonomyGeriatric Pharmacist
License Number045117
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: