Most Relevant Information
Provider Data
| NPI Number: | 1003567215 |
| Provider Name: | KIERRA K CALICO APRN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 209028348 |
Most Important Dates
| Enumeration Date: | 01/10/2022 |
| Last Updated: | 10/03/2023 |
Provider Practice Location
12855 N 40 DR STE 375
SAINT LOUIS
MO
631418657
Practice Location Phone/Fax
| Phone: | 3145676071 |
| Fax: | 3144539965 |
Provider Mailing Location
12855 N 40 DR STE 375
SAINT LOUIS
MO
631418657
Provider Mailing Phone/Fax
| Phone: | 3145676071 |
| Fax: | 3144539965 |