Healthcare Provider Details

I. General information

NPI: 1871074120
Provider Name (Legal Business Name): BRITTANY MICHELLE MULVEY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2018
Last Update Date: 11/15/2021
Certification Date: 11/02/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3015 N BALLAS RD DEPT EMERGENCY MEDICINE
SAINT LOUIS MO
63131-2329
US

IV. Provider business mailing address

660 S EUCLID AVE CB 8072
SAINT LOUIS MO
63110-1010
US

V. Phone/Fax

Practice location:
  • Phone: 314-966-5000
  • Fax: 314-747-3338
Mailing address:
  • Phone: 314-996-5225
  • Fax: 314-991-0943

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2018024331
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: