Individual
MRS. JACQUELINE LEE CARR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
12990 MANCHESTER RD, 101, DES PERES, MO 63131-1860
(314) 567-3567
(314) 567-6575
Mailing address
12990 MANCHESTER ROAD, 101, DES PERES, MO 63131-1860
(314) 567-3567
(314) 567-6575
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
2012015191
MO
Other
Enumeration date
09/28/2012
Last updated
09/28/2012
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