Healthcare Provider Details

I. General information

NPI: 1104367580
Provider Name (Legal Business Name): BARBARA MERZ BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2017
Last Update Date: 03/17/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6643 SHEPLEY DR
SAINT LOUIS MO
63105-2354
US

IV. Provider business mailing address

1 BROOKINGS DR CAMPUS BOX 1201
SAINT LOUIS MO
63130-4862
US

V. Phone/Fax

Practice location:
  • Phone: 314-965-6666
  • Fax:
Mailing address:
  • Phone: 314-965-6666
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1986104389
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: