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General NPI Number Information
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NPI Number | 1851721583
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Entity Type | Individual
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Provider Name | SUSAN HERENA ACNP
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Gender | Female
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Dates
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Enumeration Date | 11/15/2013
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | ONE CITYPLACE DRIVE SUITE 570
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7067
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Country | US
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Telephone | 314-514-6000
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Fax | 866-497-1239
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Provider Business Mailing Address
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Address Line | 999 EXECUTIVE PARKWAY DR SUITE 210
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6336
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Country | US
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Telephone |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 26NR15225100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 4182561
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License Number State | NY
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