Individual provider · Type 1 NPI
Mary L. Mallory, NURSE PRACTIONER
Community Health Nurse Practitioner · St. Louis, MO
NPI number
1801087796
Active
Practice location
401 Holly Hills Ave
St. Louis, MO 63111-2410
Fax (314) 353-1310
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Nurse Practitioner Primary | 363LC1500X | 058328 (MO) |
Community Health Nurse Practitioner: Definition to come...
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About NPI 1801087796
Mary L. Mallory, NURSE PRACTIONER's National Provider Identifier is 1801087796, issued on Aug 6, 2007. The primary taxonomy on file is Community Health Nurse Practitioner (363LC1500X), and the practice location is in St. Louis, MO. The record was last updated on Jul 1, 2014.