Healthcare Provider Details

I. General information

NPI: 1831211382
Provider Name (Legal Business Name): NANCY ABRAM RNC, NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 05/16/2022
Certification Date: 05/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHILDRENS PL
SAINT LOUIS MO
63110-1002
US

IV. Provider business mailing address

1115 BIG SKY DR
FENTON MO
63026-5677
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-6037
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number107540
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: