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General NPI Number Information
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NPI Number | 1952828584
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Entity Type | Individual
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Provider Name | MEGHAN CRISMON BEZAIRE FNP
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Gender | Female
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Dates
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Enumeration Date | 08/24/2017
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Last Update Date | 11/18/2022
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Provider Practice Location Address
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Address Line | 1020 N MASON RD DIV SURG CT ADULT CARDIO, STE 100
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6666
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Country | US
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Telephone | 314-362-7260
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Fax | 314-747-0917
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE MSC 8234-05-02
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 314-362-7260
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Fax | 314-362-6288
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2022033501
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License Number State | MO
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