Healthcare Provider Details

I. General information

NPI: 1629041884
Provider Name (Legal Business Name): KATHRYN HELEN KRANBUHL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN KRANBUHL M.D.

II. Dates (important events)

Enumeration Date: 02/08/2006
Last Update Date: 11/06/2023
Certification Date: 11/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13001 N OUTER 40 RD STE 320
TOWN AND COUNTRY MO
63017-5941
US

IV. Provider business mailing address

PO BOX 419052
SAINT LOUIS MO
63141-9052
US

V. Phone/Fax

Practice location:
  • Phone: 314-567-7337
  • Fax: 314-851-4476
Mailing address:
  • Phone: 314-567-7337
  • Fax: 314-851-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2003009172
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: