MS. MARY ELIZABETH CRECELIUS (NPI# 1841272861) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841272861 |
| Entity Type | Individual |
| Full Name | MS. MARY ELIZABETH CRECELIUS |
| Credential | WHNP |
| Practice Address |
255 Boderman Bloomsdale MO 63627 |
| Mailing Address |
Po Box 366 Ste Genevieve MO 63670-0366 |
| Practice Telephone | 5738832727 |
| Mailing Telephone | 5738835715 |
| Mailing Fax Number | 5738832463 |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2019-07-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LW0102X |
Nurse Practitioner Specialization: Women's Health |
089458 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| N | 170300000X | Genetic Counselor, MS | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | 428718712 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 800 Ste Genevieve Dr, Ste Genevieve, MO 636701434 | 5738835715 | 5738832463 |
| Street Address |
255 BODERMAN |
| City | BLOOMSDALE |
| State | MO |
| Zip Code | 63627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710974019 | Theresa A Cavins | Surgery | 255 Boderman, Bloomsdale, MO 63627-9099 | 2005-10-02 |
| 1669989786 | Jill Mccalister | Pharmacist | 255 Boderman, Bloomsdale, MO 63627-9099 | 2018-01-10 |
| 1144730615 | Jacqueline M Wolk | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2017-10-10 |
| 1437668969 | Lisa Engle | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2017-09-27 |
| 1538616362 | Melissa Ann Naeger | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2016-09-09 |
| 1609243013 | Cristella Patricia Torres | Family Medicine | 255 Boderman, Bloomsdale, MO 63627 | 2015-09-01 |
| 1063813046 | Regine Politte | Nurse Practitioner | 255 Boderman, Bloomsdale, MO 63627-9099 | 2014-09-10 |
| 1699028415 | Ste Genevieve County Memorial Hospital | Pharmacy | 255 Boderman, Suite 1e, Bloomsdale, MO 63627 | 2012-10-17 |
| 1194075200 | Ste. Genevieve County Memorial Hospital | General Practice | 255 Boderman, Suite 2a, Bloomsdale, MO 63670 | 2012-09-17 |
| 1477803583 | Ste Genevieve County Memorial Hospital | Surgery | 255 Boderman, Suite 1b, Bloomsdale, MO 63627 | 2012-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861745689 | Jessica Drury | Pharmacist | 255 Boderman Lane, Suite 1e, Bloomsdale, MO 63627 | 2012-10-17 |
| 1710239496 | Kimberly L Browne | Registered Nurse | 255 Boderman Road, Bloomsdale, MO 63627 | 2012-10-05 |
| 1558544239 | Heather Ladonn Huck | Occupational Therapist | 63 Meyer Lane, Bloomsdale, MO 63627 | 2007-12-17 |
| 1336328087 | Drury Chiropractic and Family Wellness LLC | Chiropractor | 92 Mill Hill Rd, Bloomsdale, MO 63627 | 2007-10-30 |
| 1316144652 | Donna Kay Nicholson | Counselor | 8984 State Rt. Dd, Bloomsdale, MO 63627 | 2007-06-29 |
| 1225181159 | Jodi M. Naeger | Speech-Language Pathologist | 6279 Highway 61, Bloomsdale, MO 63627-8904 | 2007-01-22 |
| 1932714748 | Adam Paul Schwent | Physical Therapist | 9748 E Cottonwood Ln, Bloomsdale, MO 63627-8955 | 2020-09-09 |
| 1124448386 | Tina Howe | Counselor | 8699 Jackson School Rd, Bloomsdale, MO 63627-9038 | 2014-04-25 |
| 1932663648 | Maria Rose Hermann | Student in an Organized Health Care Education/Training Program | 11671 State Route Y, Bloomsdale, MO 63627-9068 | 2019-01-27 |
| 1871841395 | Ste Genevieve County Memorial Hospital | Clinic/Center | 255 Boderman Dr, Bloomsdale, MO 63627-9099 | 2012-08-15 |
| Find all providers in zip 63627 | ||||
| Taxonomy Code | 363LW0102X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Women's Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356956304 | Andrea Marie Sleeth | Nurse Practitioner | 3329 W Sexton St, Springfield, MO 65810-1080 | 2020-09-15 |
| 1972112720 | Amy Elizabeth Richardson | Nurse Practitioner | 306 E Summit St, Doniphan, MO 63935-1332 | 2020-07-28 |
| 1417578873 | Saskia Naomi Chaskelson | Nurse Practitioner | 1309 Louisville Ave, Saint Louis, MO 63139-3421 | 2020-04-27 |
| 1811531395 | Melanie Melissa Miranda | Nurse Practitioner | 23 Clayton Ter, Frontenac, MO 63131-2920 | 2019-10-29 |
| 1902450695 | Erica Walter | Nurse Practitioner | 4590 Childrens Pl Fl 4, Saint Louis, MO 63110-1020 | 2019-07-31 |
| 1285288274 | Megan Cecile Johnson | Nurse Practitioner | 7924 Ne 53rd St, Kansas City, MO 64119-4149 | 2019-07-28 |
| 1255839916 | Valerie Latrice Johnson | Nurse Practitioner | 2796 N Lindbergh Blvd, Florissant, MO 63033-1402 | 2018-01-29 |
| 1801305677 | Courtney E Turnbough | Nurse Practitioner | 621 S New Ballas Rd Ste 2002b, Saint Louis, MO 63141-8265 | 2017-09-25 |
| 1710357280 | Terri Lablance | Nurse Practitioner | 3905 Bernard Powell Dr, Kansas City, MO 64127-3427 | 2015-09-28 |
| 1932443058 | Catherine Griffin | Nurse Practitioner | 33 Ayrshire Rd., St. Charles, MO 63303-3129 | 2012-11-15 |
| Find all providers with the same taxonomy | ||||
| City | BLOOMSDALE |
| Zip Code | 63627 |
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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.