| Amanda Bertholomey, | |
|
452 Sovereign Ct, Ballwin, MO 63011-4447 | |
| (636) 222-8699 | |
| Not Available |
| Full Name | Amanda Bertholomey |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner - Family |
| Location | 452 Sovereign Ct, Ballwin, Missouri |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871103093 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | 2020026219 (Missouri) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | 2014018635 (Missouri) | Primary |
| Entity Name | Mercy Aco Clinical Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1063965093 PECOS PAC ID: 6901188572 Enrollment ID: O20170117001888 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Bertholomey, 215 Cedar Mountain Dr, Robertsville, MO 63072-2018 Ph: (314) 913-0306 | Amanda Bertholomey, 452 Sovereign Ct, Ballwin, MO 63011-4447 Ph: (636) 222-8699 |
Dr. Mary Nancy Van Aman, DNP, RN, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 816 Big Bend Woods Dr, Ballwin, MO 63021 Phone: 314-412-0898 | |
Ann Elizabeth Cribbin, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 13861 Manchester Rd, Ballwin, MO 63011 Phone: 636-220-1117 | |
Brant Harber, NP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 639 Castle Ridge Dr, Ballwin, MO 63021 Phone: 314-210-9095 | |
Ms. Christina Michelle Blaesing, MSN, APRN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15945 Clayton Rd Ste 320, Ballwin, MO 63011 Phone: 636-256-5350 | |
Catherine Dolphin Smith, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15945 Clayton Rd Ste 120b, Ballwin, MO 63011 Phone: 636-256-5070 Fax: 636-256-5066 | |
Ms. Jennifer Sharon Giltner, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15945 Clayton Rd Ste 330, Ballwin, MO 63011 Phone: 573-480-0771 Fax: 636-256-5396 | |
Mrs. Kimberly Marie Wickline, AGNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 15945 Clayton Rd Ste 340, Ballwin, MO 63011 Phone: 636-256-5130 |