Individual
MS. JENNIFER SHINE HERTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
11125 DUNN RD STE 100, SAINT LOUIS, MO 63136-6132
(314) 653-5000
Mailing address
1 BRONZE POINTE BLVD STE 1A, SWANSEA, IL 62226-1045
(618) 233-7055
(618) 233-9055
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2004030088
MO
207LP2900X
Pain Medicine (Anesthesiology) Physician
209010646
IL
363L00000X
Nurse Practitioner
Primary
2013009799
MO
363L00000X
Nurse Practitioner
209010646
IL
363LA2200X
Adult Health Nurse Practitioner
209010646
IL
Other
Enumeration date
04/15/2013
Last updated
03/19/2025
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