Healthcare Provider Details

I. General information

NPI: 1083127344
Provider Name (Legal Business Name): MARY KRISTIN SEYMOUR MSN, RN, APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2017
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8515 DELMAR BLVD STE 230
SAINT LOUIS MO
63124-2168
US

IV. Provider business mailing address

8515 DELMAR BLVD STE 230
SAINT LOUIS MO
63124-2168
US

V. Phone/Fax

Practice location:
  • Phone: 314-307-7305
  • Fax:
Mailing address:
  • Phone: 314-307-7305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number155981
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: