Healthcare Provider Details

I. General information

NPI: 1467736058
Provider Name (Legal Business Name): KATHERINE MICHELE BRUST PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2011
Last Update Date: 02/11/2023
Certification Date: 02/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1718 CATLIN DR
BARNHART MO
63012-1277
US

IV. Provider business mailing address

1718 CATLIN DR
BARNHART MO
63012-1277
US

V. Phone/Fax

Practice location:
  • Phone: 636-461-1347
  • Fax: 636-461-1718
Mailing address:
  • Phone: 636-461-1347
  • Fax: 636-461-1718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2010027741
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: