Provider Demographics
NPI:1760066112
Name:DRENNAN, KATHRYN MICHELLE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:KATHRYN
Middle Name:MICHELLE
Last Name:DRENNAN
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60352
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63160-0352
Mailing Address - Country:US
Mailing Address - Phone:314-362-4211
Mailing Address - Fax:888-315-6494
Practice Address - Street 1:4901 FOREST PARK AVE
Practice Address - Street 2:DEPT OBGYN, STE 710
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-1495
Practice Address - Country:US
Practice Address - Phone:314-362-4211
Practice Address - Fax:888-315-6494
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021013599363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420096931Medicaid