Individual
MRS. JESSICA LYNN BOEDEKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
621 S NEW BALLAS RD STE 5003B, SAINT LOUIS, MO 63141-8270
(314) 251-8892
Mailing address
74 LILLEY LN, ELSBERRY, MO 63343-3167
(636) 236-2980
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2018032910
MO
Other
Enumeration date
06/20/2019
Last updated
08/23/2019
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