Healthcare Provider Details

I. General information

NPI: 1952699811
Provider Name (Legal Business Name): TRACEY KREIPE DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/13/2011
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 CAMBRIDGE BLVD STE 300
O FALLON IL
62269-4010
US

IV. Provider business mailing address

4121 UNION RD STE 201
SAINT LOUIS MO
63129-1070
US

V. Phone/Fax

Practice location:
  • Phone: 314-930-3520
  • Fax: 314-930-3675
Mailing address:
  • Phone: 314-930-3520
  • Fax: 314-930-3675

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026014750
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number209027876
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: