Healthcare Provider Details

I. General information

NPI: 1104475029
Provider Name (Legal Business Name): MS. KAREN GREER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2019
Last Update Date: 09/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4108 W FLORISSANT AVE
SAINT LOUIS MO
63115-3056
US

IV. Provider business mailing address

4108 W FLORISSANT AVE
SAINT LOUIS MO
63115-3056
US

V. Phone/Fax

Practice location:
  • Phone: 314-477-2979
  • Fax: 314-869-5954
Mailing address:
  • Phone: 314-477-2979
  • Fax: 314-869-5954

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: