Individual
MRS. JENNIFER LYNN QUISENBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4700
(314) 364-6350
Mailing address
15740 S OUTER 40 RD, CHESTERFIELD, MO 63017-2004
(636) 237-4700
(314) 364-6350
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2011038689
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111060009
MEDICARE PTAN
MO
Enumeration date
11/28/2011
Last updated
08/24/2023
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