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NPI Code Detail

MEDICARE: MRS. GRACE B PELOWSKI APRN

MEDICARE: MRS. GRACE B PELOWSKI APRN
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
1363LA2200XAdult Health Nurse PractitionerAPRN11006037FL
2363LA2200XAdult Health Nurse Practitioner433478NY
3363LA2200XAdult Health Nurse Practitioner15249CT

General Provider Information

NPI Number : 1750907077
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GRACE B PELOWSKI APRN
Provider Business Mailing Address
First Line : 30 MARYLAND PLZ
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-1556
Country : US
Telephone Number : 314-720-1644
Fax Number :
Provider Business Practice Location Address
First Line : 30 MARYLAND PLZ
Second Line :
City : SAINT LOUIS
State : MO
Zip : 63108-1556
Country : US
Telephone Number : 314-720-1644
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/23/2020
Last Update Date : 03/04/2026

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