Healthcare Provider Details

I. General information

NPI: 1053651885
Provider Name (Legal Business Name): VISITING NURSE ASSOCIATION OF GREATER ST. LOUIS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/14/2013
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2029 WOODLAND PKWY STE 105
SAINT LOUIS MO
63146-4267
US

IV. Provider business mailing address

2029 WOODLAND PKWY STE 105
SAINT LOUIS MO
63146-4267
US

V. Phone/Fax

Practice location:
  • Phone: 314-918-7171
  • Fax: 314-513-9950
Mailing address:
  • Phone: 314-918-7171
  • Fax: 314-513-9950

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License NumberN00028650
License Number StateMO

VIII. Authorized Official

Name: MS. KARI KRUEGER
Title or Position: REGIONAL VICE PRESIDENT, FINANCE
Credential:
Phone: 608-260-3567