Provider Demographics
NPI:1518148428
Name:EBERHARDT, AMY CHRISTINE (WHNP)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:CHRISTINE
Last Name:EBERHARDT
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:MISS
Other - First Name:AMY
Other - Middle Name:CHRISTINE
Other - Last Name:WITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:WHNP
Mailing Address - Street 1:670 MASON RIDGE CENTER DR
Mailing Address - Street 2:STE 300
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-8573
Mailing Address - Country:US
Mailing Address - Phone:314-996-7777
Mailing Address - Fax:314-996-4073
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:SUITE 675D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-996-7777
Practice Address - Fax:314-996-7560
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004019004363LW0102X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health