Individual
TAMMY JETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4066 DUNNICA AVE, SAINT LOUIS, MO 63116-3510
(636) 224-1724
Mailing address
4066 DUNNICA AVE, SAINT LOUIS, MO 63116-3510
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2001021703
MO
Other
Enumeration date
12/06/2016
Last updated
12/06/2016
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