Healthcare Provider Details

I. General information

NPI: 1417884594
Provider Name (Legal Business Name): MS. WENDY CATHERINE SIGURDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4488 FOREST PARK AVE STE 301
SAINT LOUIS MO
63108-2215
US

IV. Provider business mailing address

238 CARLYLE LAKE DR
SAINT LOUIS MO
63141-7544
US

V. Phone/Fax

Practice location:
  • Phone: 314-369-9430
  • Fax: 314-747-7060
Mailing address:
  • Phone: 314-369-9430
  • Fax: 314-369-9430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number123040
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: