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General NPI Number Information
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NPI Number | 1285508184
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Entity Type | Individual
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Provider Name | STEPHANIE FAULKINGHAM DNP
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Gender | Female
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Dates
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Enumeration Date | 10/02/2025
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 1040 N MASON RD STE 201
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6366
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Country | US
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Telephone | 314-985-8035
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Fax |
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Provider Business Mailing Address
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Address Line | 1040 N MASON RD STE 201
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City | SAINT LOUIS
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State | MO
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Zip | 63141-6366
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Country | US
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Telephone | 314-985-8035
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2025040263
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License Number State | MO
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