Provider Demographics
NPI:1740701762
Name:KROWNAPPLE KARE, PC
Entity type:Organization
Organization Name:KROWNAPPLE KARE, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONSULTANT
Authorized Official - Prefix:MS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:JO
Authorized Official - Last Name:KAUL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-814-3889
Mailing Address - Street 1:3400 S JEFFERSON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63118-3120
Mailing Address - Country:US
Mailing Address - Phone:314-380-0104
Mailing Address - Fax:314-260-1136
Practice Address - Street 1:3400 SOUTH JEFFERSON
Practice Address - Street 2:
Practice Address - City:ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63118-3120
Practice Address - Country:US
Practice Address - Phone:314-380-0104
Practice Address - Fax:314-260-1136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2008031123103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty