Healthcare Provider Details

I. General information

NPI: 1952764987
Provider Name (Legal Business Name): KATHARINE MARGARET MCNELLY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2016
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ DIV IM ENDOCRINOLOGY
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

PO BOX 959203
SAINT LOUIS MO
63195-9354
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-3500
  • Fax: 314-230-1119
Mailing address:
  • Phone: 314-996-7014
  • Fax: 314-273-0140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number209014024
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2022030498
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: