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NPI Code Detail

MEDICARE: MR. MATTHEW DAVID TELMER FNP

MEDICARE: MR. MATTHEW DAVID TELMER FNP
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
1363L00000XNurse Practitioner2018034196MO
2363LF0000XFamily Nurse Practitioner2018034196MO

General Provider Information

NPI Number : 1760954952
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MATTHEW DAVID TELMER FNP
Provider Business Mailing Address
First Line : 15740 S OUTER 40 RD
Second Line :
City : CHESTERFIELD
State : MO
Zip : 63017-2004
Country : US
Telephone Number : 636-237-4700
Fax Number : 314-364-6350
Provider Business Practice Location Address
First Line : 20 PROGRESS POINT PKWY STE 206
Second Line :
City : O FALLON
State : MO
Zip : 63368-2207
Country : US
Telephone Number : 636-344-1073
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/28/2018
Last Update Date : 04/16/2026

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Directions to “ MR. MATTHEW DAVID TELMER FNP” Practice Location

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