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General NPI Number Information
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NPI Number | 1215529870
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Entity Type | Individual
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Provider Name | ANN ELIZABETH CRIBBIN
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Gender | Female
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 02/05/2021
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Provider Practice Location Address
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Address Line | 13861 MANCHESTER RD
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City | BALLWIN
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State | MO
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Zip | 63011-4503
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Country | US
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Telephone | 636-220-1117
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Fax |
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Provider Business Mailing Address
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Address Line | 1296 MAUTENNE DR
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City | MANCHESTER
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State | MO
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Zip | 63021-5663
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Country | US
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Telephone | 314-791-7397
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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 | 2020006975
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License Number State | MO
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