Individual
JENNIFER TESTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
920 N MAIN ST, O FALLON, MO 63366-1746
(636) 696-1561
(636) 696-1560
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2012035265
MO
363LF0000X
Family Nurse Practitioner
2012035265
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010309
—
VT
Enumeration date
06/18/2006
Last updated
10/27/2020
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