Healthcare Provider Details

I. General information

NPI: 1275708521
Provider Name (Legal Business Name): CHERYL L. RICHARD APRN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/28/2008
Last Update Date: 04/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

ONE BARNES-JEWISH HOSPITAL PLAZA
ST. LOUIS MO
63110
US

IV. Provider business mailing address

2050 HANNAH DR
WENTZVILLE MO
63385
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-5000
  • Fax:
Mailing address:
  • Phone: 636-887-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number124437
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: