Healthcare Provider Details

I. General information

NPI: 1376626259
Provider Name (Legal Business Name): CYNTHIA S. BECHTEL RN, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1715 DEER TRACKS TRL STE 110
SAINT LOUIS MO
63131-1854
US

IV. Provider business mailing address

7235 SHAFTESBURY AVE
SAINT LOUIS MO
63130-3042
US

V. Phone/Fax

Practice location:
  • Phone: 314-919-2600
  • Fax: 314-919-2677
Mailing address:
  • Phone: 314-726-5675
  • Fax: 314-919-2677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number50986
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: