Healthcare Provider Details

I. General information

NPI: 1871236380
Provider Name (Legal Business Name): KAREN MARIE KORTE APRN FNP BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2022
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

856 WATERBURY FALLS DR STE 202
O FALLON MO
63368-2220
US

IV. Provider business mailing address

856 WATERBURY FALLS DR STE 202
O FALLON MO
63368-2220
US

V. Phone/Fax

Practice location:
  • Phone: 636-366-0610
  • Fax: 833-740-4330
Mailing address:
  • Phone: 636-366-0610
  • Fax: 833-740-4330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022019419
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: