Healthcare Provider Details

I. General information

NPI: 1407918386
Provider Name (Legal Business Name): KATRINA ZLATARIC PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2006
Last Update Date: 04/11/2023
Certification Date: 04/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7141 METROPOLITAN BLVD STE 103
BARNHART MO
63012-2604
US

IV. Provider business mailing address

7141 METROPOLITAN BLVD STE 103
BARNHART MO
63012-2604
US

V. Phone/Fax

Practice location:
  • Phone: 636-352-2346
  • Fax: 314-690-4002
Mailing address:
  • Phone: 636-352-2346
  • Fax: 314-690-4002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number141987
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number141987
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: