Healthcare Provider Details

I. General information

NPI: 1104511286
Provider Name (Legal Business Name): ROTAS NURSING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/05/2023
Last Update Date: 12/18/2023
Certification Date: 12/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5786 WESTPHALIA LN
SAINT LOUIS MO
63129-4114
US

IV. Provider business mailing address

5786 WESTPHALIA LN
SAINT LOUIS MO
63129-4114
US

V. Phone/Fax

Practice location:
  • Phone: 314-585-3023
  • Fax:
Mailing address:
  • Phone: 314-585-3023
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: ANNE WAMBUI
Title or Position: OWNER
Credential: RN
Phone: 314-585-3023