Provider Demographics
NPI:1730132143
Name:THURAU, RUTH A (NP)
Entity type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:A
Last Name:THURAU
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 S WOODS MILL RD
Mailing Address - Street 2:STE. 670 SOUTH
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-3451
Mailing Address - Country:US
Mailing Address - Phone:314-469-2182
Mailing Address - Fax:314-469-5725
Practice Address - Street 1:224 S WOODS MILL RD
Practice Address - Street 2:STE. 670 SOUTH
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-3451
Practice Address - Country:US
Practice Address - Phone:314-469-2182
Practice Address - Fax:314-469-5725
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO105982363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
500026716OtherRAILROAD MEDICARE
ILK17658Medicare ID - Type Unspecified
P11754Medicare UPIN
500026716OtherRAILROAD MEDICARE