Provider Demographics
NPI:1811997505
Name:ROWE, KRISTEN L (MD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:L
Last Name:ROWE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1413 WENTZVILLE PKWY
Mailing Address - Street 2:
Mailing Address - City:WENTZVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63385-3407
Mailing Address - Country:US
Mailing Address - Phone:636-332-5400
Mailing Address - Fax:636-332-5404
Practice Address - Street 1:300 MEDICAL PLZ
Practice Address - Street 2:SUITE 310
Practice Address - City:LAKE ST LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63367-1481
Practice Address - Country:US
Practice Address - Phone:636-625-2662
Practice Address - Fax:636-625-6623
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2011-09-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC23869208000000X
MO2007033674208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1356644306OtherURGENT CARE FOR KIDS NPI
MO207725409Medicaid
SCT80926Medicaid
MO207725409Medicaid