Healthcare Provider Details

I. General information

NPI: 1205586112
Provider Name (Legal Business Name): KIRSTEN MARAE HUFF WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2022
Last Update Date: 04/18/2025
Certification Date: 12/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3023 N BALLAS RD STE 440D
SAINT LOUIS MO
63131-2330
US

IV. Provider business mailing address

PO BOX 7412065
CHICAGO IL
60674-2065
US

V. Phone/Fax

Practice location:
  • Phone: 314-432-8181
  • Fax: 314-432-0090
Mailing address:
  • Phone: 314-432-8181
  • Fax: 314-432-0090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number2021038739
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: