Individual
MRS. JENNIFER ANN KONKOL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPM, CLC, BSW
Contact information
Practice address
3271 ROGER PL, SAINT LOUIS, MO 63116-3838
(618) 610-4777
(618) 462-0603
Mailing address
3006 ALBY ST, ALTON, IL 62002-4401
(618) 610-4777
(618) 462-0603
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10030014
NORTH AMERICAN REGISTRY OF MIDWIVES - CERTIFIED PROFESSIONAL MIDWIFE CERT #
—
Enumeration date
09/09/2010
Last updated
09/09/2010
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