NPI 1346695939 · live from the CMS NPI Registry
Judith Domenica Brusatti, APRN-CNP
Nurse Practitioner, Pediatrics in Saint Louis, MO. National Provider Identifier 1346695939, active.
NPI record
| NPI | 1346695939 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Pediatrics 363LP0200X |
| Practice location | 1465 S Grand Blvd, Saint Louis, MO 63104 |
| Practice phone | 314-268-4107 |
| Enumerated | May 2, 2016 |
| Last updated | November 4, 2020 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Nurse Practitioner, Pediatrics primary | 363LP0200X | 113802 (MO) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.