Individual
JESSICA MANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1081
(314) 454-4124
(314) 454-4595
Mailing address
1 CHILDRENS PL, SAINT LOUIS, MO 63110-1002
(314) 471-4730
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
71013410A
IN
363LP0222X
Critical Care Pediatric Nurse Practitioner
Primary
2010002603
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074790137
MEDICARE
IN
Enumeration date
10/17/2007
Last updated
04/07/2026
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