Provider Demographics
NPI:1821056888
Name:MAYS, ARDELL (WHCNP)
Entity Type:Individual
Prefix:MRS
First Name:ARDELL
Middle Name:
Last Name:MAYS
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:MS
Other - First Name:ARDELL
Other - Middle Name:
Other - Last Name:SUDDUTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:5701 DELMAR BLVD.
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63112-2617
Mailing Address - Country:US
Mailing Address - Phone:314-367-7848
Mailing Address - Fax:314-367-2985
Practice Address - Street 1:11642 WEST FLORISSANT AVE.
Practice Address - Street 2:
Practice Address - City:FLORISSANT
Practice Address - State:MO
Practice Address - Zip Code:63033-6723
Practice Address - Country:US
Practice Address - Phone:314-838-8220
Practice Address - Fax:314-838-4007
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO115206363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner