MADELINE JANE DISTLER (NPI# 1053911297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053911297 |
| Entity Type | Individual |
| Full Name | MADELINE JANE DISTLER |
| Credential | AGACNP |
| Practice Address |
4590 Childrens Pl Stop 90-29916 Saint Louis MO 63110-1020 |
| Practice Telephone | 3142733194 |
| Mailing Telephone | 3142733194 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LC0200X |
Nurse Practitioner Specialization: Critical Care Medicine |
2020012267 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4590 CHILDRENS PL STOP 90-29916 |
| City | SAINT LOUIS |
| State | MO |
| Zip Code | 63110-1020 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659971992 | Carrie Ellen Smith | Nurse Practitioner | Mailstop 90-00-174, One Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-10-27 |
| 1881210466 | Michelle Amanda Freilich | Internal Medicine | Barnes-jewish Plaza, St. Louis, MO 63110 | 2020-06-19 |
| 1245856046 | Jeevin Shahi | Radiology | 3685 Vista Avenue, Center for Radiation Medicine, St. Louis, MO 63110 | 2020-06-18 |
| 1497371314 | Wilson Eduardo Rodriguez | Student in an Organized Health Care Education/Training Program | 1008 S. Spring, St Louis, MO 63110 | 2020-06-17 |
| 1578184065 | Kathryn Kay Lindsay | Registered Nurse | Saint Louis University Dept of Surgery, 3635 Vista Ave 3dt, St Louis, MO 63110 | 2020-05-06 |
| 1881232700 | Ashley Diane Pace | Nurse Practitioner | 1 Parkview Place, Shoenberg 6900, St. Louis, MO 63110 | 2019-12-11 |
| 1619520418 | Krithika Damodar Shenoy | Pathology | 660 Euclid Avenue, One Barnes Jewish Hospital Plaza, St. Louis, MO 63110 | 2019-07-20 |
| 1467912550 | Ian Ferguson | Dermatology | 660 S Euclid Ave., Cb 8123, St. Louis, MO 63110 | 2019-03-23 |
| 1760978688 | Ihab Hassanieh | Student in an Organized Health Care Education/Training Program | 33660 Vista Ave, St. Louis, MO 63110 | 2018-07-03 |
| 1336634500 | Martin K Mwangi | Pediatrics | 1 Childrens Place, 3s34, St. Louis, M, MO 63110 | 2018-06-28 |
| Find all providers in zip 63110 | ||||
| Taxonomy Code | 363LC0200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Critical Care Medicine |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437797727 | Jonathan C Kyonka | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Saint Louis, MO 63110-1003 | 2019-12-17 |
| 1063858090 | Suzanne Elaine Bohnker | Nurse Practitioner | 999 Executive Parkway Dr, Suite 210, Saint Louis, MO 63141-6336 | 2013-05-16 |
| 1396978938 | Douglas John Harwood | Nurse Practitioner | 1 Barnes Jewish Hospital Plz, Neurology/neurosurgery Icu, Saint Louis, MO 63110-1003 | 2009-08-31 |
| 1619138591 | Juanita H Hoyte | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2008-06-23 |
| 1396960951 | Holly E Gannon | Nurse Practitioner | 1465 S Grand Blvd, Saint Louis, MO 63104-1003 | 2007-04-16 |
| 1497800197 | Patricia Lynn Nash | Nurse Practitioner | 10010 Kennerly Rd, Saint Louis, MO 63128-2106 | 2007-01-24 |
| 1891700217 | Angela Lee Tabaka | Nurse Practitioner | 3015 N Ballas Rd, St Louis, Saint Louis, MO 63131-2329 | 2006-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003949587 | Kristin C Robertson | Nurse Practitioner | 805 Gulf St., Lamar, MO 64759-1238 | 2007-03-13 |
| 1215915889 | Devona J Gibbs | Nurse Practitioner | 196 Timber Ridge Trl, Poplar Bluff, MO 63901-1595 | 2006-01-04 |
| 1588194427 | Amanda Agee | Nurse Practitioner | 15740 S Outer 40 Rd, Chesterfield, MO 63017 | 2017-06-13 |
| 1306206677 | Mara Wear | Nurse Practitioner | 4401 Wornall Road, Kansas City, MO 64111 | 2016-03-01 |
| 1609235506 | Renae Brines | Nurse Practitioner | 4401 Wornall Road, Kansas City, MO 64111 | 2016-02-19 |
| 1275991523 | Heather Boyd | Nurse Practitioner | 4401 Wornall Road, Kansas City, MO 64111 | 2016-02-02 |
| 1376916478 | Nathan Hagen | Nurse Practitioner | 4401 Wornall Rd, Kansas City, MO 64111-3220 | 2015-11-11 |
| 1902279110 | Gibbs Wound Care LLC | Nurse Practitioner | 2210 Barron Rd, Room 205, Poplar Bluff, MO 63901-1908 | 2015-11-10 |
| 1427473859 | Michaela Parsel | Nurse Practitioner | 4401 Wornall Rd, Kansas City, MO 64111-3220 | 2014-02-21 |
| 1194149310 | Molly Hope Schapker | Nurse Practitioner | 4440 Broadway St, Kansas City, MO 64111-3315 | 2014-02-07 |
| Find all providers with the same taxonomy | ||||
| City | SAINT LOUIS |
| Zip Code | 63110 |
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| 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.