| Organization Name: | NANCY M. BIRTLEY, LLC |
| NPI Number: | 1003933631 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PATRICE M FLANAGAN (PRACTICE MANAGER) |
| Mailing Address: | 6209 Mid Rivers Mall Dr #317 Saint Peters |
| State: | MO US |
| Postal Code: | 633041102 |
| Phone Number: | 6362444500 |
| Fax Number: | 6362444505 |
| NPI Enumeration Date: | 03/26/2007 |
| NPI Last Update Date: | 11/21/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0809X |
| License Number: | 107603 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Adult |
| Taxonomy Definition: | |