Individual
MRS. JORI MARIE DERNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, DIV PED HEMATOLOGY & ONC, STE 9S, SAINT LOUIS, MO 63110-1002
(314) 454-6018
(844) 621-4392
Mailing address
1 CHILDRENS PL, MSC 8515-87-1200, SAINT LOUIS, MO 63110-1002
(314) 454-6018
(314) 454-2780
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2016038522
MO
363LP0200X
Pediatric Nurse Practitioner
2016038522
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
420038846
—
MO
Enumeration date
11/28/2016
Last updated
11/15/2021
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