Individual
JESSICA WHITLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 DES PERES RD STE 310, SAINT LOUIS, MO 63131-2039
(314) 821-1313
Mailing address
PO BOX 776084, CHICAGO, IL 60677-6084
(314) 821-1313
(314) 821-5670
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
2006032006
MO
363LF0000X
Family Nurse Practitioner
Primary
2015039026
MO
Other
Enumeration date
10/26/2015
Last updated
09/20/2023
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