Mary L. Mallory, NURSE PRACTIONER

Primary specialty

Community Health Nurse PractitionerTaxonomy code 363LC1500X

License

058328 Issued in MO

Practice address

401 Holly Hills Ave
Saint Louis, MO 63111-2410

Phone

(314) 353-5190

Fax

(314) 353-1310

NPI assigned

Aug 6, 2007

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1186358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1404172800000",
    "number": "1801087796",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HOLLY HILLS AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631112410",
            "telephone_number": "314-353-5190",
            "fax_number": "314-353-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLORY",
        "first_name": "MARY",
        "middle_name": "L.",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-06",
        "last_updated": "2014-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LC1500X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Community Health",
            "state": "MO",
            "license": "058328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Mallette, PNP-AC
• Meher S Mallick, M.D.
• Laura Mallinger, DO
• Maureen Mallon, M.A.
• Lois Margaret Mallory, LCSW
• Ashok R Mallya, MD
• Raziya Mallya, MD
• Kelly Malon, P.T.
• Andrew Francis Malone, MD
• Christopher Devin Malone, MD

• Community Health Nurse Practitioner in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Community Health Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.