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General NPI Number Information
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NPI Number | 1891747135
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Entity Type | Individual
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Provider Name | EILEEN ROSENKOETTER APRN, BC, FNP
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Gender | Female
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 12700 SOUTHFORK RD # 200220
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City | SAINT LOUIS
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State | MO
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Zip | 63128-3206
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Country | US
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Telephone | 314-272-2728
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Fax |
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Provider Business Mailing Address
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Address Line | 1428 BRIARCREEK DR
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City | SAINT LOUIS
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State | MO
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Zip | 63122-5450
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Country | US
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Telephone | 573-747-9510
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 052186
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License Number State | MO
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