Provider Demographics
NPI:1639209745
Name:STOUT, JULIE MAY (ANP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:MAY
Last Name:STOUT
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:MS
Other - First Name:JULIE
Other - Middle Name:MAY
Other - Last Name:SCHEUMBAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ANP-BC
Mailing Address - Street 1:6 SILVER LN
Mailing Address - Street 2:
Mailing Address - City:KIRKWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63122-5819
Mailing Address - Country:US
Mailing Address - Phone:314-278-6712
Mailing Address - Fax:
Practice Address - Street 1:15945 CLAYTON RD STE 310
Practice Address - Street 2:
Practice Address - City:BALLWIN
Practice Address - State:MO
Practice Address - Zip Code:63011-2493
Practice Address - Country:US
Practice Address - Phone:636-863-1356
Practice Address - Fax:636-893-1358
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO086973363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health