Provider Demographics
NPI:1831588086
Name:GREMAUD, BARBARA ANNE (CNM, APRN, CPM)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANNE
Last Name:GREMAUD
Suffix:
Gender:F
Credentials:CNM, APRN, CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:772 YALE AVE
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY CITY
Mailing Address - State:MO
Mailing Address - Zip Code:63130-3119
Mailing Address - Country:US
Mailing Address - Phone:314-422-3303
Mailing Address - Fax:
Practice Address - Street 1:4390 LINDELL BLVD
Practice Address - Street 2:SUITE D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2735
Practice Address - Country:US
Practice Address - Phone:314-422-3303
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-12
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041489826163W00000X
MO128920163W00000X
MO2021002798176B00000X, 367A00000X
MO14080008176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
No163W00000XNursing Service ProvidersRegistered Nurse
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife