Individual
JENNIFER JOY JACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
10777 SUNSET OFFICE DR STE 110, SAINT LOUIS, MO 63127-1019
(314) 781-7415
(314) 644-4592
Mailing address
1010 HOLLYBEND DR, BALLWIN, MO 63021-6537
(314) 276-1428
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
152024
MO
Other
Enumeration date
04/17/2007
Last updated
01/30/2019
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