Provider Demographics
NPI:1427854579
Name:RAHENKAMP, MAUREEN ELAINE (BSN)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:ELAINE
Last Name:RAHENKAMP
Suffix:
Gender:
Credentials:BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5400 MEXICO RD APT 1305
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERS
Mailing Address - State:MO
Mailing Address - Zip Code:63376-1084
Mailing Address - Country:US
Mailing Address - Phone:636-699-0185
Mailing Address - Fax:
Practice Address - Street 1:4301 EDMUNDSON RD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63134-3909
Practice Address - Country:US
Practice Address - Phone:314-493-6368
Practice Address - Fax:314-429-6735
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-20
Last Update Date:2025-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017006615163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty