Healthcare Provider Details

I. General information

NPI: 1164148201
Provider Name (Legal Business Name): ABBIGAIL HLINAK PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBIGAIL WEBSTER PA-C

II. Dates (important events)

Enumeration Date: 10/19/2022
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

615 S NEW BALLAS RD
SAINT LOUIS MO
63141-8221
US

IV. Provider business mailing address

3415 LEMP AVE
SAINT LOUIS MO
63118-3216
US

V. Phone/Fax

Practice location:
  • Phone: 314-251-6339
  • Fax: 314-251-4564
Mailing address:
  • Phone: 660-888-8128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2022040393
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: