Healthcare Provider Details

I. General information

NPI: 1881574093
Provider Name (Legal Business Name): KRISTINE S FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2025
Last Update Date: 09/08/2025
Certification Date: 09/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1520 WENTZVILLE PKWY
WENTZVILLE MO
63385-3408
US

IV. Provider business mailing address

302 BLACK OAK CT
SAINT PETERS MO
63376-1747
US

V. Phone/Fax

Practice location:
  • Phone: 636-497-4060
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number2011017769
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: