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General NPI Number Information
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NPI Number | 1194683193
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Entity Type | Individual
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Provider Name | MAXWELL JEDEDIAH VRUWINK RN
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Gender | Male
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Dates
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Enumeration Date | 01/10/2026
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Last Update Date | 01/10/2026
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Provider Practice Location Address
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Address Line | 1 BARNES JEWISH HOSPITAL PLZ
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1003
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Country | US
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Telephone | 314-747-3000
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Fax |
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Provider Business Mailing Address
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Address Line | 7316 PERSHING AVE APT 2E
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City | UNIVERSITY CITY
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State | MO
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Zip | 63130-4211
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Country | US
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Telephone | 616-965-6099
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 2025054360
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License Number State | MO
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