Individual
JENNIFER LEE SPEISER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
12545 OLIVE BLVD, SAINT LOUIS, MO 63141-6311
(314) 786-5389
Mailing address
12545 OLIVE BLVD, SAINT LOUIS, MO 63141-6311
(314) 786-5389
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2020032248
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2020032248
LICENSE
MO
Enumeration date
11/04/2020
Last updated
11/04/2020
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