Healthcare Provider Details

I. General information

NPI: 1619138591
Provider Name (Legal Business Name): JUANITA H HOYTE NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2008
Last Update Date: 11/17/2020
Certification Date: 11/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S GRAND BLVD
SAINT LOUIS MO
63104-1003
US

IV. Provider business mailing address

2040 BARCELONA DR
FLORISSANT MO
63033-2803
US

V. Phone/Fax

Practice location:
  • Phone: 314-577-5631
  • Fax:
Mailing address:
  • Phone: 314-839-9020
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License Number064259
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: