Healthcare Provider Details

I. General information

NPI: 1215754882
Provider Name (Legal Business Name): CAITLIN LESINSKI CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2024
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4251 FOREST PARK AVE
SAINT LOUIS MO
63108-2810
US

IV. Provider business mailing address

4251 FOREST PARK AVE
SAINT LOUIS MO
63108-2810
US

V. Phone/Fax

Practice location:
  • Phone: 800-230-7526
  • Fax: 314-533-1586
Mailing address:
  • Phone: 314-531-7526
  • Fax: 314-533-1586

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number209.031657
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number2024027170
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: