Healthcare Provider Details

I. General information

NPI: 1922911734
Provider Name (Legal Business Name): KELLY PATRICIA CAHALIN MSN, CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1465 S GRAND BLVD
SAINT LOUIS MO
63104-1003
US

IV. Provider business mailing address

1465 S GRAND BLVD ALLERGY/IMMUNOLOGY DEPARTMENT
SAINT LOUIS MO
63104-1003
US

V. Phone/Fax

Practice location:
  • Phone: 314-268-4014
  • Fax:
Mailing address:
  • Phone: 314-268-4014
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number2026025200
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: