Active NPI
Mary Nancy Van Aman, DNP, RN, FNP-BC
- Family Nurse Practitioner
- Ballwin, MO
National Provider Identifier
1063842219
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 2010012193
- Practice address
- 816 Big Bend Woods Dr
Ballwin, MO 63021-7555 - Phone
- (314) 412-0898
- NPI assigned
- Nov 24, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2010012193 | MO | Primary |
Addresses
Primary practice location
816 Big Bend Woods Dr
Ballwin, MO 63021-7555
Mailing address
816 Big Bend Woods Dr
Ballwin, MO 63021-7555
Phone (314) 412-0898
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2010012193 | MO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1385251200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1385251200000",
"number": "1063842219",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "816 BIG BEND WOODS DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217555",
"telephone_number": "314-412-0898"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "816 BIG BEND WOODS DR",
"city": "BALLWIN",
"state": "MO",
"postal_code": "630217555",
"telephone_number": "314-412-0898"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VAN AMAN",
"first_name": "MARY",
"middle_name": "NANCY",
"name_prefix": "Dr.",
"credential": "DNP, RN, FNP-BC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-24",
"last_updated": "2013-11-24",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "2010012193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ballwin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.