Individual
MS. JESSICA S COLLINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
12634 OLIVE BLVD, SAINT LOUIS, MO 63141-6337
(314) 996-8378
(314) 996-8910
Mailing address
660 S EUCLID AVE, C B 8054, SAINT LOUIS, MO 63110-1010
(314) 996-8378
(314) 996-8910
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2001027050
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112438613
—
MO
Enumeration date
05/23/2007
Last updated
11/15/2011
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