MS. CARLISS RENE GARRETT (NPI# 1154680288) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1154680288 |
Entity Type | Individual |
Full Name | MS. CARLISS RENE GARRETT |
Credential | ANP |
Practice Address |
4488 Forest Park Ave Saint Louis MO 63108-2215 |
Mailing Address |
660 S Euclid Ave C B 8111 Saint Louis MO 63110-1010 |
Practice Telephone | 3142862683 |
Practice Fax Number | 3142862448 |
Mailing Telephone | 3142862683 |
Mailing Fax Number | 3142862448 |
Enumeration Date | 2012-05-09 |
Last Update Date | 2018-01-24 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2004031044 | MO | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | ENROLLED | 05 | |
MO | 1154680288 | 05 |
Street Address |
4488 FOREST PARK AVE |
City | SAINT LOUIS |
State | MO |
Zip Code | 63108-2215 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164428454 | Claudette J Kurz | Nurse Practitioner | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2005-06-22 |
1033453527 | Washington Univ Clinical Associates | Clinic/Center | 4488 Forest Park Ave, Suite 230, Saint Louis, MO 63108-2215 | 2012-11-21 |
1407084627 | Davis Clancy Ryman | Psychiatry & Neurology | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2009-06-25 |
1053561266 | Suzanne Elizabeth Schindler | Psychiatry & Neurology | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2008-09-24 |
1700065554 | Cassandra K Ward | Nurse Practitioner | 4488 Forest Park Ave, Ground Fl Healthkey Bldg Ste 160, Saint Louis, MO 63108-2215 | 2007-10-29 |
1134318751 | Dana E Ankney | Emergency Medicine | 4488 Forest Park Ave, Ste 230, Saint Louis, MO 63108-2283 | 2007-10-19 |
1497959977 | Erik Steven Musiek | Psychiatry & Neurology | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2007-06-11 |
1033254248 | Forest Park Pediatrics, P.C. | Pediatrics | 4488 Forest Park Ave, Suite 230, Saint Louis, MO 63108-2215 | 2007-02-21 |
1093733800 | David B Carr | Internal Medicine | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2006-07-18 |
1679590186 | Samuel Klein | Nutritionist | 4488 Forest Park Ave, Saint Louis, MO 63108-2215 | 2006-07-17 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
Find all providers in zip 63108 |
Taxonomy Code | 363LA2200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Adult Health |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023619285 | Jennifer Lee Speiser | Nurse Practitioner | 12545 Olive Blvd, Saint Louis, MO 63141-6311 | 2020-11-04 |
1265045264 | Andrea Jane Montgomery | Nurse Practitioner | 444 Honeysuckle Ln, Saint Louis, MO 63119-4521 | 2020-08-28 |
1396362224 | Erin M Kehoe | Nurse Practitioner | 12973 Olive Blvd, Saint Louis, MO 63141-6149 | 2020-06-26 |
1508482506 | Matthew Dale Tieskoetter | Nurse Practitioner | 333 S Kirkwood Rd Ste 203, Saint Louis, MO 63122-6161 | 2020-06-25 |
1861033615 | Benedicta Esi | Nurse Practitioner | 6024 Pennsylvania Ave, Saint Louis, MO 63111-2555 | 2019-10-02 |
1245896893 | Katina D Smith | Nurse Practitioner | 8820 Mcnulty Dr, Saint Louis, MO 63114-4146 | 2019-05-18 |
1912413584 | Lucija Kozul Sadl | Nurse Practitioner | 3525 Forest Dale Dr, Saint Louis, MO 63125-4212 | 2017-12-19 |
1275071326 | Kathryn Ries | Nurse Practitioner | 3535 South Broadway, Suite 118, Saint Louis, MO 63118-3907 | 2017-02-09 |
1144775966 | Hienok Hailu | Nurse Practitioner | 11725 Casa Grande Dr, Saint Louis, MO 63146-4223 | 2016-08-22 |
1992167522 | Lanyn Clark | Nurse Practitioner | 40 Ladue Ter, Saint Louis, MO 63124-2048 | 2016-03-23 |
Find all providers in SAINT LOUIS |
City | SAINT LOUIS |
Zip Code | 63108 |
Please comment or provide details below to improve the information on MS. CARLISS RENE GARRETT.
Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.