CHARITY KOSTELAC (NPI# 1629475934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629475934 |
| Entity Type | Individual |
| Full Name | CHARITY KOSTELAC |
| Credential | NP |
| Practice Address |
3960 Lindell Blvd Saint Louis MO 63108-3204 |
| Mailing Address |
319 Pleasant Ridge Rd Fairview Heights IL 62208-1208 |
| Practice Telephone | 3146520100 |
| Mailing Telephone | 8145988284 |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2016-03-15 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | 2014035980 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2014035980 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3960 LINDELL BLVD |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63108-3204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992721260 | David A Parks, Md, PC | Clinic/Center | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2006-07-13 |
| 1013533181 | Centralwest Immunologic Research Foundation | Clinic/Center | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2020-06-24 |
| 1487298725 | Brian Brennan | Nurse Practitioner | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2019-10-30 |
| 1558821538 | Patrick John Radler | Nurse Practitioner | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2019-03-25 |
| 1831691435 | Lisa Sanders | Pharmacist | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2018-02-28 |
| 1730681339 | Kristen Danielle Badger | Pharmacist | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2018-02-28 |
| 1952773822 | Jenna Cook | Nurse Practitioner | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2015-10-30 |
| 1720321490 | Jeana D Ring | Pharmacist | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2013-04-01 |
| 1861746026 | Efthemia Davelis | Pharmacist | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2012-11-08 |
| 1689801714 | Schnuck Markets Inc. | Registered Nurse | 3960 Lindell Blvd, Saint Louis, MO 63108-3204 | 2009-06-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346851474 | Nigel Austen Thomas Cook | Social Worker | 4050 West Pine Blvd. Apt. 4118, St. Louis, MO 63108 | 2020-08-12 |
| 1467070011 | C2n Diagnostics, LLC | Clinical Medical Laboratory | 20 South Sarah Street, Saint Louis, MO 63108 | 2020-07-10 |
| 1609414358 | Kaylee Breitenbucher | Occupational Therapist | 4444 Forest Park Avenue, Msc 8505-94-01, St. Louis, MO 63108 | 2019-12-12 |
| 1114419546 | Activangels Home Health | Home Health | 4625 Lindell Blvd Ste 304, Saint Louis, MO 63108 | 2018-06-01 |
| 1215427349 | Heart To Heart Consolidated Home Care Service LLC | Home Health | 4625 Lindell Blvd Ste 200, Saint Louis, MO 63108 | 2018-05-15 |
| 1447755905 | Erin Virginia Adams | Student in an Organized Health Care Education/Training Program | 4355 Maryland Ave Apt 116, Saint Louis, MO 63108 | 2018-03-27 |
| 1033621172 | Roots Healthcare and Homes | In Home Supportive Care | 4300 Enright Ave, St. Louis, MO 63108 | 2017-10-30 |
| 1336661719 | House of Destiny Adult Day Care LLC | Clinic/Center | 4507 Olive Street, St Louis, MO 63108 | 2017-07-07 |
| 1003338492 | Khin Min Thu | Social Worker | 4236 Lindell Blvd., Suite 200, St Louis, MO 63108 | 2017-07-07 |
| 1679093967 | Together We Can Home Healthcare Services LLC | Home Health | 4144 Lindell Blvd Suite 221, Saint Louis, MO 63108 | 2017-06-27 |
| Find all providers in zip 63108 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134720816 | Blake Christian Cory | Nurse Practitioner | 615 S Ballas Rd # 2015, Saint Louis, MO 63122-5314 | 2020-11-08 |
| 1265032346 | Sara Lynn Gillespie | Nurse Practitioner | 2424 S 9th St Apt 215, Saint Louis, MO 63104-4717 | 2020-10-28 |
| 1174123509 | Megan Ashley Wagner | Nurse Practitioner | 10012 Kennerly Rd Ste 406, Saint Louis, MO 63128-2197 | 2020-10-26 |
| 1467059972 | Anissa Rasul | Nurse Practitioner | 10631 Thayer Dr, Saint Louis, MO 63123-6018 | 2020-10-07 |
| 1124635388 | Brittney Sherrell Burks | Nurse Practitioner | 10314 Briar Hollow Dr Apt 7, Saint Louis, MO 63146-5777 | 2020-09-30 |
| 1629684865 | Nicole Burdge | Nurse Practitioner | 9230 Laurel Hill Dr, Saint Louis, MO 63126-2820 | 2020-09-22 |
| 1932724614 | Oluwatoyin Olufunke Adegboyega | Nurse Practitioner | 3318 Saint Vincent Ave, Saint Louis, MO 63104-1338 | 2020-06-09 |
| 1497376487 | Jessica A Spring | Nurse Practitioner | 6023 Lansdowne Ave, Saint Louis, MO 63109-2243 | 2020-04-30 |
| 1932728466 | Lucy Wachuka Kamau | Nurse Practitioner | 4412 Clarence Ave, Saint Louis, MO 63115-3108 | 2020-04-14 |
| 1275169567 | Lindsay Jones | Nurse Practitioner | 1115 Olivette Executive Pkwy Ste 100, Saint Louis, MO 63132-3265 | 2020-03-18 |
| Find all providers in SAINT LOUIS | ||||
| City | SAINT LOUIS |
| Zip Code | 63108 |
Please comment or provide details below to improve the information on CHARITY KOSTELAC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.