Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Your Village Stl LLC

Organization Pediatrics Physician · NPI 1205552643

Your Village Stl LLC is a Pediatrics Physician in Wildwood, Missouri. Registered with an NPI since 2022.

In the registry since
2022
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1719 Big Horn Basin Dr
Wildwood, MO 63011-4821
Phone: (314) 753-3982
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X

Record details

NPI number1205552643
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jennifer Tietjen — Owner · (314) 753-3982
NPI enumeratedOctober 18, 2022
Last updated in NPPESOctober 18, 2022
Certification dateOctober 18, 2022
Mailing address1719 Big Horn Basin Dr, Wildwood, MO 63011-4821

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