Healthcare Provider Details

I. General information

NPI: 1700664901
Provider Name (Legal Business Name): NATALIE FAYE BABB FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/20/2023
Certification Date: 09/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 BOWLES AVE STE 300
FENTON MO
63026-2387
US

IV. Provider business mailing address

1741 STONEY TERRACE DR
BALLWIN MO
63021-7783
US

V. Phone/Fax

Practice location:
  • Phone: 636-496-5048
  • Fax:
Mailing address:
  • Phone: 314-369-6887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number2018029749
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2023038351
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: