Healthcare Provider Details

I. General information

NPI: 1831588086
Provider Name (Legal Business Name): BARBARA ANNE GREMAUD CNM, APRN, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2015
Last Update Date: 03/11/2021
Certification Date: 03/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4390 LINDELL BLVD SUITE D
SAINT LOUIS MO
63108-2735
US

IV. Provider business mailing address

772 YALE AVE
UNIVERSITY CITY MO
63130-3119
US

V. Phone/Fax

Practice location:
  • Phone: 314-422-3303
  • Fax:
Mailing address:
  • Phone: 314-422-3303
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041489826
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number128920
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number2021002798
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2021002798
License Number StateMO
# 5
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number14080008
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: