Healthcare Provider Details

I. General information

NPI: 1538322565
Provider Name (Legal Business Name): DONNA WENZELBURGER RNC, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2008
Last Update Date: 07/09/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3844 S LINDBERGH BLVD SUITE 200
SAINT LOUIS MO
63127-1368
US

IV. Provider business mailing address

3844 S LINDBERGH BLVD SUITE 200
SAINT LOUIS MO
63127-1368
US

V. Phone/Fax

Practice location:
  • Phone: 314-842-0240
  • Fax:
Mailing address:
  • Phone: 314-842-0240
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License Number091029
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: