VICKIE JOANN CARLL ANP NPI 1710902176

NPI Information

NPI: 1710902176
Provider Name: VICKIE JOANN CARLL, ANP
Classification: Nurse Practitioner - 363LA2200X
Entity Type: Individual

Specialization: Adult Health

Organization: SOUND PHYSICIANS OF ILLINOIS LLC

PECOS Registration: Yes

Address:
6420 CLAYTON RD
SAINT LOUIS, MO
ZIP 63117
Phone: (314) 317-0600
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Vickie Joann Carll, ANP is an adult health nurse practitioner in Saint Louis, MO with 35 years of experience. Vickie Joann Carll, ANP NPI is 1710902176. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

6420 CLAYTON RD
SAINT LOUIS, MO
ZIP 63117-811
Phone: (314) 317-0600
Fax: (314) 317-0606

The NPI 1710902176 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2006 and was last updated on 8/15/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2200X	Nurse Practitioner	Adult Health	109547	MISSOURI	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1710902176	MEDICAID	MISSOURI
2	P22478	MEDICARE UPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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