Healthcare Provider Details

I. General information

NPI: 1922934975
Provider Name (Legal Business Name): ELIZABETH ROLWING DNP, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15740 S OUTER 40 RD
CHESTERFIELD MO
63017-2004
US

IV. Provider business mailing address

PO BOX 103
GORDONVILLE MO
63752-0103
US

V. Phone/Fax

Practice location:
  • Phone: 314-364-7343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number2026028071
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: