MEDICARE: MS. SANDRA L FORNEY CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367A00000X	Advanced Practice Midwife	082074	MO
2	363LW0102X	Women's Health Nurse Practitioner	082074	MO

General Provider Information

NPI Number	:	1043305022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SANDRA L FORNEY CNM

Provider Business Mailing Address
First Line	:	660 S EUCLID AVE
Second Line	:	C B 8064
City	:	SAINT LOUIS
State	:	MO
Zip	:	63110-1010
Country	:	US
Telephone Number	:	314-454-7882
Fax Number	:	314-454-5167

Provider Business Practice Location Address
First Line	:	4901 FOREST PARK AVE
Second Line	:	STE 341
City	:	SAINT LOUIS
State	:	MO
Zip	:	63108-1402
Country	:	US
Telephone Number	:	314-454-7882
Fax Number	:	314-454-5167

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	02/07/2017

Similar Medicare Providers

1386647345 — DR. GEORGE A MACONES MD
Practice Location Address:

4901 FOREST PARK AVE STE 710 , STE 710
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-454-8181
Practice Fax: 314-747-1429

1467455964 — DR. EDMOND S WEISBART MD
Practice Location Address:

4901 FOREST PARK AVE , WOHL CLINIC STE 241
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-362-5060
Practice Fax: 314-362-6959

1659342913 — DR. THOMAS J BLANKE MD
Practice Location Address:

4901 FOREST PARK AVE , STE 420
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-362-9100
Practice Fax: 314-362-9107

1962420463 — DR. DONALD M NELSON MD
Practice Location Address:

4901 FOREST PARK AVE STE 710 , STE 710
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-454-8181
Practice Fax: 314-747-1429

1457379133 — DR. CARLA J SIEGFRIED MD
Practice Location Address:

4901 FOREST PARK AVE FL 6 , 6TH FL
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-362-3937
Practice Fax: 314-362-3725

1437172459 — DR. DIANE F MERRITT MD
Practice Location Address:

4901 FOREST PARK AVE STE 710 , STE 710
SAINT LOUIS, MO
63108-1402

Practice Phone: 314-273-4724
Practice Fax: 314-747-1481

Directions to “ MS. SANDRA L FORNEY CNM” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.