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General NPI Number Information
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NPI Number | 1922676188
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Entity Type | Organization
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Legal Business Name | REAL RN RECRUITER
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Dates
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Enumeration Date | 06/15/2021
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 925 MADISON AVE FRNT
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City | MADISON
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State | IL
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Zip | 62060-1316
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Country | US
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Telephone | 314-602-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 4728 LOCKE AVE
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City | SAINT LOUIS
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State | MO
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Zip | 63109-2722
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Country | US
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Telephone | 314-602-7340
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCH NURSE PRACTITIONER
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Name | DR. AUDREY FAULSTICH
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Credential | DNP, APRN, PMHNP-BC
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Telephone | 314-602-7340
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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 |
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License Number State |
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