Individual
MRS. JESSICA ELAINE HENKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4320 FOREST PARK AVE, STE 1100, SAINT LOUIS, MO 63108-2979
(314) 333-4100
(314) 333-4115
Mailing address
PO BOX 7412037, CHICAGO, IL 60674-2037
(314) 333-4100
(314) 333-4115
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2020001589
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420080826
—
MO
Enumeration date
09/01/2016
Last updated
04/17/2025
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