Ms. Mary L. Mallory
Nurse Practitioner - Community Health
401 Holly Hills Ave
Saint Louis
, Missouri 63111-2410
Ms. Mary L. Mallory
Nurse Practitioner - Community Health
401 Holly Hills Ave
Saint Louis
, Missouri 63111-2410
(314) 353-1310
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About
Features
Specialties
- Nurse Practitioner - Community Health
Languages spoken
- English
Location
First Address
- Ms. Mary L. Mallory
- 401 Holly Hills Ave
- Saint Louis, MO
- Zip : 63111-2410
- Fax : (314) 353-1310
- Phone : (314) 353-5190
Second Address
- Ms. Mary L. Mallory
- 401 Holly Hills Ave
- Saint Louis, MO
- Zip : 63111-2410
- Fax : (314) 353-1310
- Phone : (314) 353-5190
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LC1500X | Nurse Practitioner - Community Health | 058328 | MO |
National Provider Identifier
| NPI | 1801087796 |
|---|---|
| Provider Name | Ms. Mary L. Mallory |
| First Address | Saint Louis, MO 63111-2410 |
| Second Address | Saint Louis, MO 63111-2410 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/08/2007 |
| Last Update Date | 01/07/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 599983 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.