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General NPI Number Information
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NPI Number | 1144714023
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Entity Type | Individual
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Provider Name | CECELIA PRATT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 06/14/2018
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 621 S NEW BALLAS RD STE 560A
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City | SAINT LOUIS
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State | MO
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Zip | 63141-8261
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Country | US
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Telephone | 314-251-6440
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Fax |
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Provider Business Mailing Address
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Address Line | 606 PRAIRIEGATE CT
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City | LAKE SAINT LOUIS
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State | MO
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Zip | 63367-4362
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Country | US
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Telephone | 636-541-4607
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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 | F03170063
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2012024057
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License Number State | MO
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