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General NPI Number Information
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NPI Number | 1417771536
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Entity Type | Individual
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Provider Name | HALEY ST PETERS CNM
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Gender | Female
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Dates
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Enumeration Date | 11/14/2024
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Last Update Date | 09/17/2025
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Provider Practice Location Address
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Address Line | 1414 CROSS ST STE 240
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City | SHILOH
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State | IL
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Zip | 62269-2941
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Country | US
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Telephone | 618-234-2390
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 959203
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City | SAINT LOUIS
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State | MO
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Zip | 63195-9203
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Country | US
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Telephone | 618-234-2390
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Fax | 618-234-9936
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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 | 163WM0102X
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Taxonomy Name | Maternal Newborn Registered Nurse
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License Number | 041496484
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 209032311
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License Number State | IL
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