Individual provider · Type 1 NPI
Matthew Charles
Psychiatric/Mental Health Nurse Practitioner · St. Louis, MO
NPI number
1770913089
Active
Practice location
10004 Kennerly Rd, Ste 364B
St. Louis, MO 63128-2141
Fax (314) 525-7260
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Psychiatric/Mental Health Registered Nurse | 163WP0809X | 2013037719 (MO) |
| Psychiatric/Mental Health Nurse Practitioner Primary | 363LP0808X | 2013037719 (MO) |
Psychiatric/Mental Health Nurse Practitioner: Definition to come...
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About NPI 1770913089
Matthew Charles's National Provider Identifier is 1770913089, issued on Nov 22, 2013. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in St. Louis, MO. The record was last updated on Mar 14, 2017.