Individual
KATHERINE GRUENKEMEYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN CPNP
Contact information
Practice address
1465 S GRAND BLVD, SAINT LOUIS, MO 63104-1003
(314) 577-5351
(314) 268-4151
Mailing address
5321 BURGUNDY DR, IMPERIAL, MO 63052-2096
(314) 577-5351
(314) 268-4151
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2005023014
MO
363LP0200X
Pediatric Nurse Practitioner
Primary
2005023014
MO
Other
Enumeration date
02/25/2009
Last updated
10/28/2020
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