Healthcare Provider Details

I. General information

NPI: 1487988093
Provider Name (Legal Business Name): KRISTEN MICHELLE CUNDIFF M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRISTEN MICHELLE COVERT M.D.

II. Dates (important events)

Enumeration Date: 09/29/2009
Last Update Date: 12/05/2025
Certification Date: 12/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

IV. Provider business mailing address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

V. Phone/Fax

Practice location:
  • Phone: 417-521-2437
  • Fax:
Mailing address:
  • Phone: 417-521-2437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2011008728
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code2080P0204X
TaxonomyPediatric Emergency Medicine (Pediatrics) Physician
License Number2011008728
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: