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General NPI Number Information
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NPI Number | 1326174079
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Entity Type | Organization
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Legal Business Name | ST JOHN'S MERCY MEDICAL GROUP
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 18 FOX VALLEY CTR
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City | ARNOLD
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State | MO
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Zip | 63010-2281
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Country | US
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Telephone | 636-282-9899
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Fax | 636-282-2279
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Provider Business Mailing Address
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Address Line | 18 FOX VALLEY CTR
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City | ARNOLD
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State | MO
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Zip | 63010-2281
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Country | US
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Telephone | 636-282-9899
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Fax | 636-282-2279
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Authorized Official
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Title or Position | FAMILY NURSE PRACTITIONER
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Name | MS. KAREN K. SLATTERY
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Credential | FNP, GNP
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Telephone | 636-282-9899
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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 | RN127212
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License Number State | MO
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