Individual
MRS. JESSICA L SHEEHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
GNP
Contact information
Practice address
12348 OLD TESSON RD STE 240, SAINT LOUIS, MO 63128-2251
(314) 467-3900
(314) 467-3919
Mailing address
PO BOX 776084, CHICAGO, IL 60677-8586
Taxonomy
Speciality
Code
Description
License number
State
163WG0600X
Gerontology Registered Nurse
209007047
IL
363L00000X
Nurse Practitioner
209007047
IL
363LG0600X
Gerontology Nurse Practitioner
Primary
209007047
IL
363LP2300X
Primary Care Nurse Practitioner
209007047
IL
Other
Enumeration date
05/31/2007
Last updated
11/06/2023
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