Provider Demographics
NPI:1982959466
Name:ARCESE, ANN EAGAN (ANP)
Entity Type:Individual
Prefix:MRS
First Name:ANN
Middle Name:EAGAN
Last Name:ARCESE
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 DES PERES RD STE 310
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2039
Mailing Address - Country:US
Mailing Address - Phone:314-821-1313
Mailing Address - Fax:314-821-5670
Practice Address - Street 1:1000 DES PERES RD STE 310
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2039
Practice Address - Country:US
Practice Address - Phone:314-821-1313
Practice Address - Fax:314-821-5670
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209009647363LA2200X
MO2019034004363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health