Healthcare Provider Details

I. General information

NPI: 1326547332
Provider Name (Legal Business Name): ALLISON MARIE BEARDSLEY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2018
Last Update Date: 05/28/2025
Certification Date: 05/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PLACE 90-32-683 SHOENBERG 1ST FLOOR
SAINT LOUIS MO
63110
US

IV. Provider business mailing address

4921 PARKVIEW PLACE 90-32-683 SHOENBERG 1ST FLOOR
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 844-776-7200
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF09170860
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberF09170860
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: