Healthcare Provider Details

I. General information

NPI: 1841130754
Provider Name (Legal Business Name): CAROLINE CHI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 03/30/2026
Certification Date: 03/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4921 PARKVIEW PL
SAINT LOUIS MO
63110-1032
US

IV. Provider business mailing address

34 HOLLANDBUSH CT
SAINT PETERS MO
63304-7569
US

V. Phone/Fax

Practice location:
  • Phone: 314-454-8134
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number2026011350
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: