Provider Demographics
NPI:1700171469
Name:NAUNHEIM, MARY E (RN)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:E
Last Name:NAUNHEIM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4684 BAYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63123-5831
Mailing Address - Country:US
Mailing Address - Phone:314-495-6992
Mailing Address - Fax:
Practice Address - Street 1:4684 BAYBROOK DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63123-5831
Practice Address - Country:US
Practice Address - Phone:314-495-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008020329163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse