Provider Demographics
NPI:1730496522
Name:ESTERS, TANIKA C (NP)
Entity Type:Individual
Prefix:
First Name:TANIKA
Middle Name:C
Last Name:ESTERS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:TANIKA
Other - Middle Name:C
Other - Last Name:MCCLARY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:10135 W FLORISSANT AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-2103
Mailing Address - Country:US
Mailing Address - Phone:314-731-7989
Mailing Address - Fax:
Practice Address - Street 1:10135 W FLORISSANT AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-2103
Practice Address - Country:US
Practice Address - Phone:314-731-7989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001020564363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health