Provider Demographics
NPI:1437954450
Name:WACHTER, KATLYN MARIE (PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:MARIE
Last Name:WACHTER
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:231 S BEMISTON AVE
Mailing Address - Street 2:STE 850 PMB 132121
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63105-1920
Mailing Address - Country:US
Mailing Address - Phone:573-458-5525
Mailing Address - Fax:
Practice Address - Street 1:706 S BISHOP AVE STE A
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-4333
Practice Address - Country:US
Practice Address - Phone:573-458-5525
Practice Address - Fax:573-202-6890
Is Sole Proprietor?:No
Enumeration Date:2025-02-14
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2025004213363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health