Provider Demographics
NPI:1174884209
Name:PRESS, KRISTIN KARLA (ACNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTIN
Middle Name:KARLA
Last Name:PRESS
Suffix:
Gender:F
Credentials:ACNP
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Mailing Address - Street 1:111 SAINT LUKES CENTER DR # 20B
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3509
Mailing Address - Country:US
Mailing Address - Phone:636-685-7745
Mailing Address - Fax:314-516-8167
Practice Address - Street 1:111 SAINT LUKES CENTER DR
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3509
Practice Address - Country:US
Practice Address - Phone:636-685-7745
Practice Address - Fax:314-576-8167
Is Sole Proprietor?:No
Enumeration Date:2012-06-05
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2012016459363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL$$$$$$$$$001Medicaid