1861337107 NPI number — LAURA SPROUS FNP

Table of content: LAURA SPROUS FNP (NPI 1861337107)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861337107 NPI number — LAURA SPROUS FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPROUS
Provider First Name:
LAURA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861337107
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12255 DEPAUL DRIVE, SUITE 600
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIDGETON
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
63044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-209-5100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 HUTCHINSON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BALLWIN
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
63011-5702
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
636-591-1086
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/22/2026

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163WC1500X , with the licence number:  2019004597 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com