Healthcare Provider Details

I. General information

NPI: 1518181536
Provider Name (Legal Business Name): ST LOUIS CHILDRENS HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/12/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S GRAND BLVD
SAINT LOUIS MO
63104-1003
US

IV. Provider business mailing address

3301 ROCK CREEK VALLEY RD
HIGH RIDGE MO
63049-3333
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-5631
  • Fax:
Mailing address:
  • Phone: 636-677-7690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number113827
License Number StateMO

VIII. Authorized Official

Name: MRS. KATHERINE ANNE ROBBINS
Title or Position: NEONATAL NURSE PRACTITIONER
Credential: RNC NNP
Phone: 636-677-7690