MEDICARE: HIWOT WOLDGEORGIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	2013005895	MO

General Provider Information

NPI Number	:	1265856215
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HIWOT WOLDGEORGIS

Provider Business Mailing Address
First Line	:	PO BOX 955534
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63195-5534
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3165 MCKELVEY RD STE 100
Second Line	:
City	:	BRIDGETON
State	:	MO
Zip	:	63044-2550
Country	:	US
Telephone Number	:	314-739-1333
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/11/2014
Last Update Date	:	01/05/2026

Similar Medicare Providers

1548207475 — PYRAMID HOME HEALTH, INC
Practice Location Address:

3165 MCKELVEY RD STE 203B
BRIDGETON, MO
63044-2550

Practice Phone: 800-381-5931
Practice Fax: 314-521-8407

1659335776 — DINU P GANGURE MD
Practice Location Address:

BJC BEHAVIORAL HEALTH, 3165 MCKELVEY RD, STE. 200
BRIDGETON, MO
63044-2550

Practice Phone: 314-206-3900
Practice Fax:

1679595623 — MRS. CYNTHIA L HORVATH SR. CSW
Practice Location Address:

3165 MCKELVEY RD , SUITE 200
BRIDGETON, MO
63044-2550

Practice Phone: 314-206-3974
Practice Fax: 314-206-3992

1518980432 — MS. TRAYNETTE JENKINS-REESE LPC
Practice Location Address:

3165 MCKELVEY RD , SUITE 200
BRIDGETON, MO
63044-2550

Practice Phone: 314-206-3465
Practice Fax: 314-206-3992

1437172319 — MS. AMY KATHLEEN VESCOVO
Practice Location Address:

3165 MCKELVEY RD , SUITE 200
BRIDGETON, MO
63044-2550

Practice Phone: 314-206-3436
Practice Fax: 314-206-3992

1689696684 — MRS. JANE JOAN CALLOWAY MA, LPC
Practice Location Address:

3165 MCKELVEY RD , SUITE 200
BRIDGETON, MO
63044-2550

Practice Phone: 314-206-3451
Practice Fax: 314-206-3992

Directions to “ HIWOT WOLDGEORGIS ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.