IndividualActive
Diane Roth, RN
NPI 1790916864 · General Practice Registered Nurse · Saint Louis, MO
Provider details
- NPI number
- 1790916864
- Entity type
- Individual
- Primary specialty
- General Practice Registered NurseNursing Service Providers
- Credential
- RN
- Sex
- Female
- Sole proprietor
- Yes
- License
- 066206 (MO)
Specialties & taxonomies
Nursing Service Providers
Practice location
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Phone: (314) 268-2700
Fax: (314) 268-2798
Approximate (ZIP-level) locationGet directions
Mailing address
1465 S Grand Blvd
Saint Louis, MO 63104-1003
Registry dates
- Enumerated
- 2009-08-06
- Last updated
- 2009-08-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.