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General NPI Number Information
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NPI Number | 1730743881
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Entity Type | Individual
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Provider Name | ELLE GRITHER MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/24/2019
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Last Update Date | 02/17/2021
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Provider Practice Location Address
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Address Line | 255 BODERMAN
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City | BLOOMSDALE
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State | MO
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Zip | 63627-9099
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Country | US
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Telephone | 573-483-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 23458 GRITHER DR
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City | SAINT MARY
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State | MO
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Zip | 63673-9068
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Country | US
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Telephone | 573-883-6284
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2019023375
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2019023375
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License Number State | MO
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