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Individual

JESSICA L ACRE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
1965 S FREMONT AVE STE 100, SPRINGFIELD, MO 65804-2299
(417) 820-3800
Mailing address
PO BOX 505164, SAINT LOUIS, MO 63150-5164
(855) 420-7900

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017023106
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PENDING
MEDICARE
MO
05
PENDING
AR
05
PENDING
MO
05
PENDING
OK
Enumeration date
06/05/2017
Last updated
04/09/2026
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