IndividualActive
Anita Blackwell, RNCPNP
NPI 1790808681 · Pediatric Nurse Practitioner · Saint Louis, MO
Provider details
- NPI number
- 1790808681
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- RNCPNP
- Sex
- Female
- Sole proprietor
- No
- License
- AP133887 (TX)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4055 Lindell Blvd
Saint Louis, MO 63108-3201
Phone: (314) 535-7701
Fax: (314) 535-0207
Approximate (ZIP-level) locationGet directions
Mailing address
12377 Merit Dr Ste 300
Dallas, TX 75251-3126
Registry dates
- Enumerated
- 2007-04-07
- Last updated
- 2022-09-22
- Certified
- 2022-09-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.