Healthcare Provider Details

I. General information

NPI: 1841195039
Provider Name (Legal Business Name): SARAH WAINZ
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 S EUCLID AVE
SAINT LOUIS MO
63110-1010
US

IV. Provider business mailing address

843 GARDENWAY DR
BALLWIN MO
63011-2815
US

V. Phone/Fax

Practice location:
  • Phone: 314-362-5096
  • Fax: 314-362-3448
Mailing address:
  • Phone: 636-229-2664
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2021026566
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: