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General NPI Number Information
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NPI Number | 1700304508
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Entity Type | Individual
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Provider Name | KARIN C WITT FNP
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Gender | Female
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 11125 DUNN RD STE 204
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6188
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Country | US
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Telephone | 314-839-5125
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Fax | 314-829-5351
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Provider Business Mailing Address
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Address Line | 11125 DUNN RD STE 204
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City | SAINT LOUIS
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State | MO
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Zip | 63136-6188
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Country | US
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Telephone | 314-839-5125
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Fax | 314-829-5351
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0414370057
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2009010907
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License Number State | MO
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