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Individual

JESSICA LYNN GENGLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.O.

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2019001308
MO
208000000X
Pediatrics Physician
5101018918
MI
208000000X
Pediatrics Physician
OS13423
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
015173300
FL
Enumeration date
07/08/2010
Last updated
01/14/2019
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