Healthcare Provider Details

I. General information

NPI: 1386596997
Provider Name (Legal Business Name): CASSIE LYNN CRABTREE CPNP-PC/AC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2026
Last Update Date: 02/14/2026
Certification Date: 02/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S GRAND BLVD
SAINT LOUIS MO
63104-1003
US

IV. Provider business mailing address

2701 WAGON WHEEL LN
LENZBURG IL
62255-1040
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-5600
  • Fax:
Mailing address:
  • Phone: 618-977-2532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2026000773
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: