Provider Demographics
NPI:1881632990
Name:WOELFEL, KRISTA D (MSN, FNP)
Entity type:Individual
Prefix:MRS
First Name:KRISTA
Middle Name:D
Last Name:WOELFEL
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:263 MADISON PARK DR
Mailing Address - Street 2:
Mailing Address - City:COTTLEVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63376-2291
Mailing Address - Country:US
Mailing Address - Phone:636-734-3163
Mailing Address - Fax:
Practice Address - Street 1:107 PIPER HILL DR
Practice Address - Street 2:SUITE 100
Practice Address - City:ST PETERS
Practice Address - State:MO
Practice Address - Zip Code:63376-1620
Practice Address - Country:US
Practice Address - Phone:636-477-8757
Practice Address - Fax:314-219-6241
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MORN 122658363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000081130OtherMEDICARE PROVIDER TRANSACTION NUMBER
MO000081130OtherMEDICARE PROVIDER TRANSACTION NUMBER