Renitra Jackson FNP

NPI 1144399270 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1144399270
Gender Female
Enumeration Date 11/06/2006
Last Updated 10/13/2014
Entity Type Individual
Active Over 10 years ago
Practice Location
1225 GRAHAM RD
#C-1330
FLORISSANT MO, 63031-8012, US
Phone (314) 838-5702
Fax (314) 839-5596
Business Location
PO BOX 23340
SAINT LOUIS MO, 63156-3340, US
Phone (314) 838-5702
Fax (314) 839-5596
Toxanomy
Taxonomy Code 363LF0000X
License State Missouri
License Number 2000164715
Remove 1144399270 NPI Number
 

According to our database, Renitra Jackson FNP NPI is 1144399270, taxonomy code is 363LF0000X and license number is 2000164715, license state is located at Missouri. Renitra Jackson FNP physically located at 1225 Graham Rd, Florissant MO, 63031-8012. NPI Number Renitra Jackson FNP has the Individual type.

Sponsored links

1144399270 NPI number is provided on an as is basis without warranty of any kind. 1144399270 is maintained by the National Plan & Provider Enumeration System. The contents of Renitra Jackson FNP are for informational purposes only.