Healthcare Provider Details
I. General information
NPI: 1053051656
Provider Name (Legal Business Name): KATHERINE ANN SCHELL NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/31/2022
Last Update Date: 10/11/2023
Certification Date: 10/11/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1027 BELLEVUE AVE STE 205
SAINT LOUIS MO
63117-1851
US
IV. Provider business mailing address
1222 COLD SPRING DR
O FALLON MO
63368-7991
US
V. Phone/Fax
- Phone: 314-768-8730
- Fax: 314-768-7171
- Phone: 417-872-1309
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | 2022006454 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: