Healthcare Provider Details

I. General information

NPI: 1326412487
Provider Name (Legal Business Name): NINA KEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2015
Last Update Date: 11/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WESTPORT PLAZA STE. 600
ST. LOUIS MO
63146
US

IV. Provider business mailing address

12362 ARDWICK LN
SAINT LOUIS MO
63146-2801
US

V. Phone/Fax

Practice location:
  • Phone: 314-363-4532
  • Fax:
Mailing address:
  • Phone: 314-363-4532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: