Provider Information for 1902295504
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CARRIE KIRCHNER
Sex: Female
NPI: 1902295504
Last Updated: 2024-07-29
Certification Date: 2024-07-29
Certification Date: 2024-07-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1902295504 | ||||||||
| Enumeration Date | 2015-01-20 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 343 S KIRKWOOD RD STE 200 SAINT LOUIS, MO 63122-4015 United States Phone: 314-206-3400 | Fax: | ||||||||
| Primary Practice Address | 10004 KENNERLY RD STE 280B SAINT LOUIS, MO 63128-2177 United States Phone: 314-251-0555 | Fax: | ||||||||
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