Healthcare Provider Details

I. General information

NPI: 1902738800
Provider Name (Legal Business Name): MIDWEST PSYCHIATRY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14414 PEMBURY DR
CHESTERFIELD MO
63017-2533
US

IV. Provider business mailing address

14414 PEMBURY DR
CHESTERFIELD MO
63017-2533
US

V. Phone/Fax

Practice location:
  • Phone: 323-541-5680
  • Fax:
Mailing address:
  • Phone: 323-541-5680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KALANIT WINTER
Title or Position: PMHNP
Credential: NURSE PRACTITIONER
Phone: 323-541-5680