Individual
MS. JENNIFER L MCINTOSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
11155 DUNN RD, SAINT LOUIS, MO 63136-6150
(314) 355-3003
(314) 355-0515
Mailing address
660 S EUCLID AVE, C B 8234, SAINT LOUIS, MO 63110-1010
(314) 366-3003
(314) 355-0515
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2002029420
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1669756946
—
MO
05
—
ENROLLED
—
IL
Enumeration date
10/04/2011
Last updated
01/24/2018
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