Individual
KAITLIN STACKABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3655 VISTA AVE FL 3, SAINT LOUIS, MO 63110-2539
(314) 617-3630
(314) 768-6614
Mailing address
3655 VISTA AVE FL 3, SAINT LOUIS, MO 63110-2539
(314) 617-3630
(314) 768-6614
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
2025020535
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/11/2022
Last updated
07/12/2025
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