Individual
MRS. JACQUELINE ELISE KIRK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10004 KENNERLY RD STE 362B, SAINT LOUIS, MO 63128-2178
(314) 525-5050
(314) 525-5072
Mailing address
10004 KENNERLY RD STE 362B, SAINT LOUIS, MO 63128-2178
(314) 525-5050
(314) 525-5072
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2021099690
MO
Other
Enumeration date
09/23/2021
Last updated
12/14/2021
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