Individual
MS. JAN M HANNEKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
4921 PARKVIEW PL, 7TH FL, SAINT LOUIS, MO 63110-1032
(314) 747-1171
(314) 362-3192
Mailing address
660 S EUCLID AVE, CB 8056, SAINT LOUIS, MO 63110-1010
(314) 747-1171
(314) 362-3192
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
092661
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IL
Enumeration date
10/18/2006
Last updated
06/13/2019
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