Individual
JENNIE M AUSTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2005031069
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200974
BLUE CROSS BLUE SHIELD
—
01
—
204990105
MEDICAID
MO
05
—
204990105
—
MO
01
—
440546366
UNITED HEALTHCARE
—
01
—
507515500
MEDICAID
MO
01
—
721499
HEALTHLINK
—
01
—
H63439
MERCY
—
Enumeration date
04/20/2006
Last updated
08/15/2012
Update your record
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