DR. DANAE AGNES NELSON (NPI# 1669979621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669979621 |
| Entity Type | Individual |
| Full Name | DR. DANAE AGNES NELSON |
| Credential | DO |
| Practice Address |
1465 S. Grand Blvd. Room 2717 St. Louis MO 63104-1003 |
| Practice Telephone | 3142684070 |
| Practice Fax Number | 3142684019 |
| Mailing Telephone | 3142684070 |
| Mailing Fax Number | 3142684019 |
| Enumeration Date | 2018-04-06 |
| Last Update Date | 2018-04-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1465 S. GRAND BLVD. ROOM 2717 |
| City | ST. LOUIS |
| State | MO |
| Zip Code | 63104-1003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336646488 | Palida Noor | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., Room 2717, St. Louis, MO 63104-1003 | 2018-04-06 |
| 1184184483 | Charles Edward Landis | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-22 |
| 1760941769 | Claire Marie Pappa | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-19 |
| 1114486115 | Matthew Carroll Minnette | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-19 |
| 1043779044 | Brian J. Glen | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-19 |
| 1598224594 | Asna Asrar | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-19 |
| 1578022570 | Anthony Michael Zunica | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-19 |
| 1487113478 | Saba Bajwa | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-18 |
| 1417416496 | Keith Zarahi Amaral | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-18 |
| 1780143776 | Rebecca Ann Rockamann | Student in an Organized Health Care Education/Training Program | 1465 S. Grand Blvd., St. Louis, MO 63104 | 2019-03-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407469570 | Family Care Health Centers | Clinic/Center | 2717 Sidney Street, St. Louis, MO 63104 | 2020-08-28 |
| 1023638038 | Laura Ann Humphrey | Physician Assistant | Allied Health Building 3437 Caroline Street, Room 3015, Saint Louis, MO 63104 | 2020-04-20 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1205359916 | Brenda Eve Ladin | Behavior Technician | 1221 Allen Market Lane Rear, St. Louis, MO 63104 | 2017-07-25 |
| 1841722063 | Gustavo G Mendez | Student in an Organized Health Care Education/Training Program | 1465 South Grand Bulevard Rm 2717, Ssm Health Cardinal Glennon Children's Hospital, Saint Louis, MO 63104 | 2017-03-28 |
| 1053776716 | Carmella Harper | Respiratory Therapist, Certified | 2678 Park Ave, St Louis, MO 63104 | 2015-12-23 |
| 1922485986 | Alexander Tremont | Internal Medicine | 1402 S Grand Blvd Rm M260, Saint Louis, MO 63104 | 2015-04-29 |
| 1306233341 | Healthcare R Us | Home Health | 2859 Sidney St, St Louis, MO 63104 | 2015-04-16 |
| 1396159091 | Daniela Hermelin | Pathology | 1402 South Grane, St. Louis, MO 63104 | 2014-06-20 |
| 1992117881 | Kelly Denise Durbin | Social Worker | 1920 S 7th St, Saint Louis, MO 63104 | 2014-05-27 |
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| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255956611 | Efehi Kelly Ogbomo | Student in an Organized Health Care Education/Training Program | 6420 Clayton Rd, Suite 2218, St. Louis, MO 63117 | 2020-06-11 |
| 1619533890 | Abdul Rauf | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road. Ssm Health St. Mary's Hospital, St. Louis, MO 63117 | 2019-05-14 |
| 1083278477 | Mohamed Maali Gumaa Mohamed | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Ssm St. Mary's Hospital, Department of Internal Medicine, St. Louis, MO 63117 | 2019-05-01 |
| 1750945556 | Samrat Jun Jayanth | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm Health St Mary's Hospital, St. Louis, MO 63117 | 2019-04-26 |
| 1174187264 | Ahsan Ali | Student in an Organized Health Care Education/Training Program | 1438 South Grand Blvd, Monteleone Hall, St. Louis, MO 63104 | 2019-04-24 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1124517289 | Jideofor Ebony Obodozie | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-05-04 |
| 1770071706 | Sivaram Prabhuji Muppaneni | Student in an Organized Health Care Education/Training Program | Ssm St Mary's Hospital, 6420 Clayton Road, St. Louis, MO 63117 | 2018-04-25 |
| 1659868354 | Francis Rafael Contreras | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road Department of Internal Medicine, Ssm St. Mary's Hospital, St. Louis, MO 63117 | 2018-04-18 |
| 1437656105 | Manjusha Thenozhiyil | Student in an Organized Health Care Education/Training Program | 6420 Clayton Road., St. Louis, MO 63117 | 2018-04-10 |
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| 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.