Healthcare Provider Details

I. General information

NPI: 1518170596
Provider Name (Legal Business Name): KAREN M GROSS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN M TOUSSAINT

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 11/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

IV. Provider business mailing address

901 PATIENTS FIRST DR
WASHINGTON MO
63090-4700
US

V. Phone/Fax

Practice location:
  • Phone: 636-239-7500
  • Fax: 636-239-2836
Mailing address:
  • Phone: 636-239-7500
  • Fax: 636-239-2836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number100677
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: