Healthcare Provider Details

I. General information

NPI: 1073423406
Provider Name (Legal Business Name): ERIC SZKLARZEWSKI RN
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2515 S BRENTWOOD BLVD
SAINT LOUIS MO
63144-2308
US

IV. Provider business mailing address

5514 BELLEMEADE TRAIL CT
SAINT LOUIS MO
63129-2377
US

V. Phone/Fax

Practice location:
  • Phone: 314-540-1162
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2025004956
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: