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General NPI Number Information
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NPI Number | 1912047515
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Entity Type | Individual
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Provider Name | REBECCA SARAH LIGHT-PEARLMAN PNP
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Gender | Female
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Dates
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Enumeration Date | 02/06/2007
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 4444 FOREST PARK AVE STE 2600
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City | SAINT LOUIS
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State | MO
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Zip | 63108-2212
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Country | US
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Telephone | 314-286-1700
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Fax | 314-286-1777
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Provider Business Mailing Address
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Address Line | PO BOX 7412011
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City | CHICAGO
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State | IL
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Zip | 60674-2011
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Country | US
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Telephone | 314-286-1700
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Fax | 314-286-1777
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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 | 364SP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 2002025109
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 2002025109
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License Number State | MO
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