Individual
JILLIAN NICOLE ETHRIDGE-BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, FNP-BC
Contact information
Practice address
4438 TELEGRAPH RD, SAINT LOUIS, MO 63129-3316
(314) 742-6000
(314) 742-6002
Mailing address
PO BOX 959354, SAINT LOUIS, MO 63195-2235
(314) 742-6000
(314) 742-6002
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041425190
IL
163W00000X
Registered Nurse
2008021433
MO
163WF0300X
Flight Registered Nurse
2008021433
MO
363L00000X
Nurse Practitioner
2016034571
MO
363LF0000X
Family Nurse Practitioner
Primary
2016034571
MO
Other
Enumeration date
01/19/2017
Last updated
09/19/2025
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