Provider Demographics
NPI:1114720893
Name:NUR, MAGDA SHEWAYE (PMHNP)
Entity type:Individual
Prefix:
First Name:MAGDA
Middle Name:SHEWAYE
Last Name:NUR
Suffix:
Gender:
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4574 VALMEYER DR
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128-2458
Mailing Address - Country:US
Mailing Address - Phone:314-482-4200
Mailing Address - Fax:
Practice Address - Street 1:4574 VALMEYER DR
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128-2458
Practice Address - Country:US
Practice Address - Phone:314-482-4200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-29
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025009570363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health