Individual
JESSIKA O TYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
(314) 604-2813
Mailing address
3015 N BALLAS RD, SAINT LOUIS, MO 63131-2329
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
2024039033
MO
367500000X
Certified Registered Nurse Anesthetist
209027699
IL
Other
Enumeration date
09/18/2021
Last updated
05/23/2025
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