Individual
JENNIFER DIANA CANALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
17300 N OUTER 40, SUITE 100, CHESTERFIELD, MO 63005-1364
(636) 519-8889
(636) 536-0120
Mailing address
436 PARKVIEW PLACE DR, ELLISVILLE, MO 63021-4642
(636) 207-7870
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2002005070
MO
Other
Enumeration date
11/25/2008
Last updated
11/25/2008
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