Individual
MS. JENNIFER LYNNE DIZES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3545 LAFAYETTE AVE, SALUS CENTER 2ND FLOOR, SAINT LOUIS, MO 63104-1314
(314) 977-9339
(314) 977-7529
Mailing address
3545 LAFAYETTE AVE, SALUS CENTER 2ND FLOOR, SAINT LOUIS, MO 63104-1314
(314) 977-9339
(314) 977-7529
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041314462
IL
163W00000X
Registered Nurse
Primary
121004
MO
Other
Enumeration date
06/11/2008
Last updated
06/11/2008
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