Individual
MS. KATHERINE J MARTIN-BREDAHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
969 N MASON RD STE 110, SAINT LOUIS, MO 63141-6338
(314) 996-3434
Mailing address
969 N MASON RD STE 110, SAINT LOUIS, MO 63141-6338
(314) 996-3434
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2009037799
MO
363L00000X
Nurse Practitioner
209023198
IL
363LF0000X
Family Nurse Practitioner
2009037799
MO
363LF0000X
Family Nurse Practitioner
209023198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427388776
—
MO
05
—
ENROLLED
—
IL
Enumeration date
01/09/2010
Last updated
01/31/2023
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