Individual provider · Type 1 NPI

Mallory Elizabeth Cusumano, NP

Nurse Practitioner · Chesterfield, MO

NPI number 1740797398 Active

Practice location

224 S Woods Mill Rd Ste 330S
Chesterfield, MO 63017-3497

Fax (314) 576-4047

Mailing address

301 Baker Ave
Webster Groves, MO 63119-3735

Specialties and licenses

TaxonomyCodeLicense
Adult Health Nurse Practitioner 363LA2200X2018004643 (MO)
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Nurse Practitioner Primary 363L00000X2018004643 (MO)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1740797398

Mallory Elizabeth Cusumano, NP's National Provider Identifier is 1740797398, issued on Jan 4, 2018. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Chesterfield, MO. The record was last updated on May 20, 2025.