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General NPI Number Information
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NPI Number | 1093007965
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Entity Type | Individual
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Provider Name | BETTY A CALLIER-GREEN
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Gender | Female
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Dates
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Enumeration Date | 05/10/2011
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Last Update Date | 05/10/2011
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Provider Practice Location Address
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Address Line | 3631 GRAVOIS AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63116-4727
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Country | US
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Telephone | 866-825-3227
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Fax |
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Provider Business Mailing Address
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Address Line | 161 WASHINGTON ST EIGHT TOWER SUITE 1400
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City | CONSHOHOCKEN
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State | PA
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Zip | 19428-2083
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2010042445
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License Number State | MO
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