Healthcare Provider Details

I. General information

NPI: 1013743681
Provider Name (Legal Business Name): HEATHER S ROUTH FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2024
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

IV. Provider business mailing address

1 BARNES JEWISH HOSPITAL PLZ
SAINT LOUIS MO
63110-1003
US

V. Phone/Fax

Practice location:
  • Phone: 314-906-2544
  • Fax: 314-747-7253
Mailing address:
  • Phone: 314-906-2544
  • Fax: 314-747-7253

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number2024008617
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: