Provider Demographics
NPI:1922676188
Name:REAL RN RECRUITER
Entity Type:Organization
Organization Name:REAL RN RECRUITER
Other - Org Name:WELLNESS PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PSYCH NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:AUDREY
Authorized Official - Middle Name:
Authorized Official - Last Name:FAULSTICH
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, PMHNP-BC
Authorized Official - Phone:314-602-7340
Mailing Address - Street 1:4728 LOCKE AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63109-2722
Mailing Address - Country:US
Mailing Address - Phone:314-602-7340
Mailing Address - Fax:
Practice Address - Street 1:925 MADISON AVE FRNT
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IL
Practice Address - Zip Code:62060-1316
Practice Address - Country:US
Practice Address - Phone:314-602-7340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty