Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kimberly Michelle Daller, FNP-BC

Individual provider Family Nurse Practitioner · NPI 1164064440

Kimberly Michelle Daller, FNP-BC is a Nurse Practitioner in Fenton, Missouri. Qualified in 2019, 7 years ago. Practices with Mercy East Ambulatory Services LLC, a 103-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
7
Licensed in
MO
In the registry since
2019
What do these letters mean?
FNP-BC — Family Nurse Practitioner, Board Certified
A family nurse practitioner certified by the ANCC.

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Practice location Address checks out

1345 Smizer Mill Rd Ste 1100
Fenton, MO 63026-7305
Phone: (636) 496-5023
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1722 Clarkson Rd, Chesterfield, MO 63017-4976 — (636) 206-2665

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 2019038326 (MO)

Record details

NPI number1164064440
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-BC
Sole proprietorNo
NPI enumeratedOctober 8, 2019
Last updated in NPPESJune 18, 2024
Certification dateJune 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Mercy East Ambulatory Services Llc — 103 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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