| Doctor Name: | MS. MARY ELIZABETH CRECELIUS |
| NPI Number: | 1841272861 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | WHNP |
| License Number: | 089458 |
| Business Practice Address: | 800 Ste Genevieve Dr Ste Genevieve, MO - 636701434 |
| Business Phone Number: | 5738835715 |
| Business Fax Number: | 5738832463 |
| Mailing Address: | 800 Ste Genevieve Dr, STE GENEVIEVE |
| State: | MO |
| Postal Code: | 636701434 |
| Phone Number: | 5738835715 |
| Fax Number: | 5738832463 |
| NPI Enumeration Date: | 11/16/2005 |
| NPI Last Update Date: | 07/11/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LW0102X |
| License Number: | 089458 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Women's Health |
| Taxonomy Definition: | |